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General NPI Number Information
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NPI Number | 1912187857
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Entity Type | Organization
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Legal Business Name | R J BETTINI
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Dates
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Enumeration Date | 11/08/2007
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Last Update Date | 07/11/2011
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Provider Practice Location Address
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Address Line | 9004 CROWNWOOD CT
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City | BURKE
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State | VA
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Zip | 22015-1630
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Country | US
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Telephone | 703-978-5440
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Fax | 703-978-0764
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Provider Business Mailing Address
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Address Line | 9004 CROWNWOOD CT
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City | BURKE
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State | VA
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Zip | 22015-1630
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Country | US
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Telephone | 703-978-5440
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Fax | 703-978-0764
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Authorized Official
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Title or Position | OWNER
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Name | DR. JANICE EMERY
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Credential | M.D.
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Telephone | 703-978-5440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0745587
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License Number State | VA
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