Healthcare Provider Details

I. General information

NPI: 1114731825
Provider Name (Legal Business Name): GIRIJA VIJAYKUMAR RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2025
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44330 MERCURE CIR STE 271
DULLES VA
20166-3802
US

IV. Provider business mailing address

40802 MARTINA CT
ALDIE VA
20105-4138
US

V. Phone/Fax

Practice location:
  • Phone: 571-293-1087
  • Fax: 703-263-8040
Mailing address:
  • Phone: 703-727-7400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: