Healthcare Provider Details

I. General information

NPI: 1427307362
Provider Name (Legal Business Name): ARLINGTON ALLERGY & ASTHMA CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2012
Last Update Date: 09/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5275 LEE HWY STE 201
ARLINGTON VA
22207-1619
US

IV. Provider business mailing address

PO BOX 7144
ARLINGTON VA
22207-0144
US

V. Phone/Fax

Practice location:
  • Phone: 703-261-4224
  • Fax: 703-649-6493
Mailing address:
  • Phone: 703-261-4224
  • Fax: 703-649-6493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number0101251659
License Number StateVA

VIII. Authorized Official

Name: MADHU B NARRA
Title or Position: MANAGER
Credential: M.D.
Phone: 703-261-4224