Healthcare Provider Details
I. General information
NPI: 1427440122
Provider Name (Legal Business Name): METROPOLITAN ENT HEARING AIDS AND ALLERGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/04/2015
Last Update Date: 03/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6355 WALKER LN SUITE 308
ALEXANDRIA VA
22310-3245
US
IV. Provider business mailing address
6355 WALKER LN SUITE 308
ALEXANDRIA VA
22310-3245
US
V. Phone/Fax
- Phone: 703-313-7700
- Fax: 703-313-0178
- Phone: 703-313-7700
- Fax: 703-313-0178
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332S00000X |
| Taxonomy | Hearing Aid Equipment |
| License Number | 0101054696 |
| License Number State | VA |
VIII. Authorized Official
Name:
MICHAEL
ABIDIN
Title or Position: CEO
Credential: M.D.
Phone: 703-313-7700