Healthcare Provider Details

I. General information

NPI: 1053487348
Provider Name (Legal Business Name): JAY S RANA MD PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 S CARLIN SPRINGS RD SUITE 511
ARLINGTON VA
22204-1064
US

IV. Provider business mailing address

611 S CARLIN SPRINGS RD SUITE 511
ARLINGTON VA
22204-1064
US

V. Phone/Fax

Practice location:
  • Phone: 703-671-7000
  • Fax: 703-379-0449
Mailing address:
  • Phone: 703-671-7000
  • Fax: 703-379-0449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101057788
License Number StateVA

VIII. Authorized Official

Name: SONIA RANA
Title or Position: OFFICE MANAGER
Credential:
Phone: 703-671-7000