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General NPI Number Information
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NPI Number | 1316551237
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Entity Type | Organization
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Legal Business Name | PINNACLE HEALTHCARE SERVICES, LLC
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Dates
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Enumeration Date | 09/08/2020
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Last Update Date | 03/04/2021
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Provider Practice Location Address
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Address Line | 4660 KENMORE AVE STE 200
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City | ALEXANDRIA
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State | VA
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Zip | 22304-1306
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Country | US
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Telephone | 703-957-9420
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Fax | 703-419-3992
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Provider Business Mailing Address
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Address Line | 1390 CHAIN BRIDGE RD # 10033
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City | MC LEAN
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State | VA
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Zip | 22101-3904
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Country | US
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Telephone | 336-624-7164
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. KURWA NEEMAT NYIGU
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Credential | MD
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Telephone | 336-624-7164
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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