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General NPI Number Information
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NPI Number | 1376635003
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Entity Type | Organization
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Legal Business Name | ROBERT S ENELOW MD AND STUART HENOCHOWICZ MD PC
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 01/21/2011
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Provider Practice Location Address
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Address Line | 6035 BURKE CENTRE PKWY SUITE 120
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City | BURKE
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State | VA
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Zip | 22015-3750
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Country | US
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Telephone | 703-425-6010
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Fax | 703-425-7504
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Provider Business Mailing Address
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Address Line | 6035 BURKE CENTRE PKWY SUITE 120
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City | BURKE
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State | VA
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Zip | 22015-3750
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Country | US
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Telephone | 703-425-6010
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Fax | 703-425-7504
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Authorized Official
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Title or Position | MANAGER
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Name | SHELLEY KREITMAN
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Credential |
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Telephone | 703-425-7550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | 0101042350
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License Number State | VA
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