Healthcare Provider Details

I. General information

NPI: 1568879682
Provider Name (Legal Business Name): LNG ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2014
Last Update Date: 03/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8301 ARLINGTON BLVD SUITE 206
FAIRFAX VA
22031-2902
US

IV. Provider business mailing address

8301 ARLINGTON BLVD SUITE 206
FAIRFAX VA
22031-2902
US

V. Phone/Fax

Practice location:
  • Phone: 703-391-3000
  • Fax:
Mailing address:
  • Phone: 703-391-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number0101250955
License Number StateVA

VIII. Authorized Official

Name: DR. JASSER THIARA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 703-391-3000