Healthcare Provider Details

I. General information

NPI: 1376609933
Provider Name (Legal Business Name): PFUNDSTEIN HOSPITALIST AND CONSULTATIVE SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 11/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 GALLOWS RD
FALLS CHURCH VA
22042-3307
US

IV. Provider business mailing address

11620 SPRINGHOUSE PL
RESTON VA
20194-1163
US

V. Phone/Fax

Practice location:
  • Phone: 703-702-0753
  • Fax: 703-668-0679
Mailing address:
  • Phone: 703-615-2990
  • Fax: 703-668-0679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101-052483
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number0101-052483
License Number StateVA

VIII. Authorized Official

Name: DR. JOANN PFUNDSTEIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 703-615-2990