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General NPI Number Information
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NPI Number | 1023688827
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Entity Type | Organization
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Legal Business Name | EVENBEAM NEUROPALLIATIVE CARE, LLC
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Dates
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Enumeration Date | 06/25/2021
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Last Update Date | 06/25/2021
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Provider Practice Location Address
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Address Line | 7112 BRADDOCK RD
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City | ANNANDALE
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State | VA
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Zip | 22003
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Country | US
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Telephone | 540-924-3258
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Fax | 856-249-9592
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Provider Business Mailing Address
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Address Line | 673 POTOMAC STATION DR NE # 605
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City | LEESBURG
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State | VA
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Zip | 20176-1819
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Country | US
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Telephone | 540-924-3258
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Fax | 856-249-9592
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. FARRAH DALY
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Credential | MD, MBA
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Telephone | 540-924-3258
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084H0002X
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Taxonomy Name | Hospice and Palliative Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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