Healthcare Provider Details

I. General information

NPI: 1316984461
Provider Name (Legal Business Name): ASTER ARAYA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 02/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 OPITZ BLVD
WOODBRIDGE VA
22191-3311
US

IV. Provider business mailing address

7033 HIGHLAND MEADOWS CT
ALEXANDRIA VA
22315-3963
US

V. Phone/Fax

Practice location:
  • Phone: 703-670-1313
  • Fax:
Mailing address:
  • Phone: 703-971-3479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101222396
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: