Healthcare Provider Details

I. General information

NPI: 1649710690
Provider Name (Legal Business Name): VIRGINIA SLEEP AND RESEARCH CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2017
Last Update Date: 08/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 PARK AVE STE 203
FALLS CHURCH VA
22046-3303
US

IV. Provider business mailing address

3400 PAYNE ST STE 100
FALLS CHURCH VA
22041-2313
US

V. Phone/Fax

Practice location:
  • Phone: 703-533-2478
  • Fax: 703-534-3409
Mailing address:
  • Phone: 703-338-0878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. AMER JAHANGIRI
Title or Position: CEO
Credential: RPSGT
Phone: 703-338-0878