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General NPI Number Information
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NPI Number | 1386596674
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Entity Type | Organization
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Legal Business Name | RISEN MEDICAL CARE INC.
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Dates
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Enumeration Date | 02/10/2026
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 1800 TOWN CENTER DR STE 220
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City | RESTON
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State | VA
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Zip | 20190-3238
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Country | US
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Telephone | 703-440-7000
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Fax | 703-440-7999
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Provider Business Mailing Address
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Address Line | 23426 SHAGBARK HICKORY LN
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City | ALDIE
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State | VA
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Zip | 20105-4126
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Country | US
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Telephone | 732-762-5580
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. RAVI KIRAN PASUNOORI
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Credential |
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Telephone | 732-762-5580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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