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General NPI Number Information
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NPI Number | 1518789122
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Entity Type | Organization
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Legal Business Name | ANNANDALE FERTILITY, INC.
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Dates
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Enumeration Date | 10/26/2024
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Last Update Date | 10/26/2024
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Provider Practice Location Address
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Address Line | 2810 OLD LEE HWY STE 305
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City | FAIRFAX
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State | VA
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Zip | 22031-4376
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Country | US
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Telephone | 703-462-8665
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Fax | 571-327-5662
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Provider Business Mailing Address
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Address Line | 2810 OLD LEE HWY STE 305
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City | FAIRFAX
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State | VA
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Zip | 22031-4376
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Country | US
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Telephone | 561-251-6936
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Fax | 571-327-5662
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Authorized Official
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Title or Position | CEO
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Name | SAMANTHA STERN
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Credential | PA-C
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Telephone | 561-251-6936
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number |
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License Number State |
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