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General NPI Number Information
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NPI Number | 1336416486
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Entity Type | Organization
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Legal Business Name | LYNC HEALTH PC
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Dates
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Enumeration Date | 11/17/2011
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Last Update Date | 11/17/2011
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Provider Practice Location Address
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Address Line | 611 S CARLIN SPRINGS RD SUITE 301
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City | ARLINGTON
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State | VA
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Zip | 22204-1064
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Country | US
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Telephone | 703-998-0480
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Fax |
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Provider Business Mailing Address
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Address Line | 6625 MADISON MCLEAN DR
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City | MC LEAN
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State | VA
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Zip | 22101-2902
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Country | US
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Telephone | 703-395-0491
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. LATHA NACHIMUTHU
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Credential | MD
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Telephone | 703-395-0491
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 0101244402
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | 0101244402
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 0101244402
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101244402
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License Number State | VA
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