Healthcare Provider Details

I. General information

NPI: 1316915796
Provider Name (Legal Business Name): ALLERGY ASTHMA AND SINUS CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 01/05/2023
Certification Date: 11/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19465 DEERFIELD AVE STE 101
LEESBURG VA
20176-1702
US

IV. Provider business mailing address

PO BOX 650668
STERLING VA
20165-0668
US

V. Phone/Fax

Practice location:
  • Phone: 703-726-9720
  • Fax: 703-726-9721
Mailing address:
  • Phone: 703-726-9720
  • Fax: 703-726-9721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BEHNAM DAGHIGH
Title or Position: PHYSICIAN
Credential: MD
Phone: 703-726-9720