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General NPI Number Information
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NPI Number | 1568690550
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Entity Type | Individual
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Provider Name | ANA MARIA MOYA PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/29/2009
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Last Update Date | 08/22/2015
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Provider Practice Location Address
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Address Line | 6712 ARLINGTON BLVD
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City | FALLS CHURCH
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State | VA
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Zip | 22042-2105
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Country | US
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Telephone | 703-534-8007
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Fax |
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Provider Business Mailing Address
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Address Line | 1635N GEORGE MASON DR 455
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City | ARLINGTON
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State | VA
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Zip | 22205-3678
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Country | US
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Telephone | 703-465-0137
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Fax | 703-465-0429
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA0110003015
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License Number State | VA
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