=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861782252
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CYRIL JOSEPH MD,PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/19/2011
-----------------------------------------------------
Last Update Date | 04/19/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 44081 PIPELINE PLZ
-----------------------------------------------------
City | ASHBURN
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 20147-5891
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 571-223-2229
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6112 OAKENGATEWAY
-----------------------------------------------------
City | CENTREVILLE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 20120
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-577-8745
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MD
-----------------------------------------------------
Name | CYRIL JOSEPH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 703-577-8745
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM2500X
-----------------------------------------------------
Taxonomy Name | Medical Specialty Clinic/Center
-----------------------------------------------------
License Number | 0101223436
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------