Healthcare Provider Details

I. General information

NPI: 1861002677
Provider Name (Legal Business Name): SIDORELA DOCI AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2020
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11800 SUNRISE VALLEY DR STE 405
RESTON VA
20191-5302
US

IV. Provider business mailing address

19110 MONTGOMERY VILLAGE AVE STE 120
MONTGOMERY VILLAGE MD
20886-3706
US

V. Phone/Fax

Practice location:
  • Phone: 703-574-8885
  • Fax: 703-415-0045
Mailing address:
  • Phone: 301-977-6317
  • Fax: 301-977-8503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number01574
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number2201001791
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: