Healthcare Provider Details

I. General information

NPI: 1871787002
Provider Name (Legal Business Name): ALLERGY AND ASTHMA ASSOCIATES P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2007
Last Update Date: 10/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6888 ELM ST SUITE 301
MC LEAN VA
22101-3894
US

IV. Provider business mailing address

6888 ELM ST SUITE 301
MC LEAN VA
22101-3894
US

V. Phone/Fax

Practice location:
  • Phone: 703-430-0833
  • Fax: 703-430-6073
Mailing address:
  • Phone: 703-430-0833
  • Fax: 703-430-6073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number0101042243
License Number StateVA

VIII. Authorized Official

Name: MRS. JILL MCREYNOLDS
Title or Position: BILLING COORDINATOR
Credential:
Phone: 703-430-0833