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General NPI Number Information
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NPI Number | 1578700423
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Entity Type | Organization
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Legal Business Name | VALLEY CARDIOVASCULAR CONSULTANTS, INC.
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Dates
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Enumeration Date | 01/14/2009
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Last Update Date | 08/22/2011
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Provider Practice Location Address
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Address Line | 817 CEDAR CREEK GRADE SUITE 100
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City | WINCHESTER
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State | VA
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Zip | 22601-2706
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Country | US
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Telephone | 540-662-8224
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Fax | 540-662-8230
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Provider Business Mailing Address
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Address Line | 817 CEDAR CREEK GRADE SUITE 100
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City | WINCHESTER
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State | VA
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Zip | 22601-2706
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Country | US
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Telephone | 540-662-8224
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Fax | 540-662-8230
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Authorized Official
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Title or Position | OWNER
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Name | JUAN M PITTALUGA
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Credential | M.D.
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Telephone | 540-662-8224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 0101050179
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License Number State | VA
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