Healthcare Provider Details

I. General information

NPI: 1518117720
Provider Name (Legal Business Name): AUDIOLOGY ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2008
Last Update Date: 09/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 CHAIN BRIDGE RD SUITE 208
MC LEAN VA
22101-4451
US

IV. Provider business mailing address

2021 K ST NW SUITE 210
WASHINGTON DC
20006-1003
US

V. Phone/Fax

Practice location:
  • Phone: 703-356-5601
  • Fax: 703-448-0380
Mailing address:
  • Phone: 202-223-3560
  • Fax: 202-223-3339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: DR. J GORDON VAP
Title or Position: PRESIDENT
Credential: M.D.
Phone: 202-223-3560