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General NPI Number Information
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NPI Number | 1831997592
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Entity Type | Organization
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Legal Business Name | NORTHERN VIRGINIA HEART & VASCULAR CENTER, LLC
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Dates
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Enumeration Date | 03/06/2025
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 13580 GROUPE DR STE 100
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City | WOODBRIDGE
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State | VA
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Zip | 22192-4166
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Country | US
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Telephone | 703-637-7270
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Fax |
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Provider Business Mailing Address
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Address Line | 13580 GROUPE DR STE 100
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City | WOODBRIDGE
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State | VA
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Zip | 22192-4166
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Country | US
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Telephone | 703-637-7270
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JESSICA S MOUNTJOY
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Credential | MBA, BSN, RN
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Telephone | 703-637-7270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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