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General NPI Number Information
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NPI Number | 1598798068
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Entity Type | Organization
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Legal Business Name | ADVANCED LAPAROSCOPIC AND GENERAL SURGERY ASSOCIATES, PLLC
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2235 CEDAR LN SUITE 302
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City | VIENNA
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State | VA
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Zip | 22182-5202
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Country | US
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Telephone | 708-778-6000
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Fax | 703-778-6005
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Provider Business Mailing Address
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Address Line | 2235 CEDAR LN SUITE 302
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City | VIENNA
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State | VA
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Zip | 22182-5202
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Country | US
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Telephone | 708-778-6000
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Fax | 703-778-6005
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | HAZEM A ELARINY
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Credential | MD
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Telephone | 703-778-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | VA
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