Healthcare Provider Details

I. General information

NPI: 1265512024
Provider Name (Legal Business Name): EDWARD S. POZARNY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 S CARLIN SPRINGS ROAD SUITE 512
ARLINGTON VA
22204
US

IV. Provider business mailing address

611 S CARLIN SPRINGS ROAD SUITE 512
ARLINGTON VA
22204
US

V. Phone/Fax

Practice location:
  • Phone: 703-820-1472
  • Fax: 703-820-3173
Mailing address:
  • Phone: 703-820-1472
  • Fax: 703-820-3173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: EDWARD S POZARNY
Title or Position: PRESIDENT
Credential: D.P.M.
Phone: 703-820-1472