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General NPI Number Information
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NPI Number | 1336338276
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Entity Type | Organization
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Legal Business Name | DR. ELENI SOLOS-KOUNTOURIS, PC
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 01/04/2008
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Provider Practice Location Address
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Address Line | 13880 BRADDOCK RD SUITE 307
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City | CENTREVILLE
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State | VA
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Zip | 20121-2459
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Country | US
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Telephone | 703-378-8994
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Fax | 703-378-7911
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Provider Business Mailing Address
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Address Line | 13880 BRADDOCK RD SUITE 307
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City | CENTREVILLE
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State | VA
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Zip | 20121-2459
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Country | US
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Telephone | 703-378-8994
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Fax | 703-378-7911
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ELENI SOLOS-KOUNTOURIS
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Credential |
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Telephone | 703-378-8994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0101058312
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License Number State | VA
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