Healthcare Provider Details

I. General information

NPI: 1619957271
Provider Name (Legal Business Name): DELLA QUERY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DELLA ENG TOW MD

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 11/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12950 HIGHLAND CROSSING DRIVE STE. H
HERNDON VA
20171
US

IV. Provider business mailing address

12950 HIGHLAND CROSSING DRIVE STE. H
HERNDON VA
20171
US

V. Phone/Fax

Practice location:
  • Phone: 703-860-4200
  • Fax: 703-860-1528
Mailing address:
  • Phone: 703-860-4200
  • Fax: 703-860-1528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101055921
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: