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General NPI Number Information
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NPI Number | 1801249404
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Entity Type | Individual
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Provider Name | ALEXA DESKO PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/19/2016
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Last Update Date | 07/13/2021
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Provider Practice Location Address
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Address Line | 3300 GALLOWS RD
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City | FALLS CHURCH
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State | VA
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Zip | 22042-3307
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Country | US
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Telephone | 703-766-4001
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Fax |
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Provider Business Mailing Address
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Address Line | 1531 N PIERCE ST APT 1004
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City | ARLINGTON
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State | VA
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Zip | 22209-2873
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Country | US
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Telephone | 610-216-8452
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110005439
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License Number State | VA
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