Healthcare Provider Details

I. General information

NPI: 1447964846
Provider Name (Legal Business Name): HELLO PEDIATRICS MEDICAL GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2023
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13135 ROUTE 50 STE 300
FAIRFAX VA
22033-1907
US

IV. Provider business mailing address

1 PENN PLZ STE 2705
NEW YORK NY
10119-2600
US

V. Phone/Fax

Practice location:
  • Phone: 855-576-8745
  • Fax: 888-494-1094
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. PAUL PORTSMORE
Title or Position: AUTHORIZED PERSON
Credential:
Phone: 855-576-8745