Healthcare Provider Details

I. General information

NPI: 1689017246
Provider Name (Legal Business Name): VAHRAM ORNEKIAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2013
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 TOWN CENTER PKWY STE 463
RESTON VA
20190-3300
US

IV. Provider business mailing address

1850 TOWN CENTER PKWY STE 463
RESTON VA
20190-3300
US

V. Phone/Fax

Practice location:
  • Phone: 571-910-7877
  • Fax: 571-910-7880
Mailing address:
  • Phone: 571-910-7877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number0101289280
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number0101289280
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: