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General NPI Number Information
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NPI Number | 1609969930
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Entity Type | Organization
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Legal Business Name | PEDIATRIC SURGICAL ASSOCIATES OF NORTHERN VIRGINIA
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Dates
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Enumeration Date | 09/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3301 WOODBURN RD SUITE 205
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City | ANNANDALE
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State | VA
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Zip | 22003-1229
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Country | US
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Telephone | 703-560-2236
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Fax | 703-876-4960
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Provider Business Mailing Address
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Address Line | 3301 WOODBURN RD SUITE 205
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City | ANNANDALE
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State | VA
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Zip | 22003-1229
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Country | US
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Telephone | 703-560-2236
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Fax | 703-876-4960
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALLYSON A. ASKEW
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Credential | M.D.
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Telephone | 703-560-2236
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0101043562
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License Number State | VA
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