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General NPI Number Information
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NPI Number | 1699633024
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Entity Type | Organization
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Legal Business Name | GG KIDNEY DIETITIAN
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Dates
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Enumeration Date | 01/14/2026
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 19490 SANDRIDGE WAY STE 120
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City | LEESBURG
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State | VA
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Zip | 20176-3469
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Country | US
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Telephone | 571-293-1087
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Fax |
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Provider Business Mailing Address
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Address Line | 40802 MARTINA CT
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City | ALDIE
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State | VA
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Zip | 20105-4138
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GIRIJA VIJAYKUMAR
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Credential | RD
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Telephone | 703-727-7400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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