=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861362097
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EAST COAST MOBILE & TRANSITIONAL CARE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/11/2025
-----------------------------------------------------
Last Update Date | 12/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11350 RANDOM HILLS RD STE 819
-----------------------------------------------------
City | FAIRFAX
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22030-6044
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-988-1080
-----------------------------------------------------
Fax | 703-988-1088
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11350 RANDOM HILLS RD STE 819
-----------------------------------------------------
City | FAIRFAX
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22030-6044
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-988-1080
-----------------------------------------------------
Fax | 703-988-1088
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MS. LIANA E MATEVOSIAN
-----------------------------------------------------
Credential | NP
-----------------------------------------------------
Telephone | 703-944-8546
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2100X
-----------------------------------------------------
Taxonomy Name | Acute Care Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------