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General NPI Number Information
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NPI Number | 1942691019
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Entity Type | Organization
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Legal Business Name | NOVA RECONSTRUCTIVE SURGERY LLC
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Dates
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Enumeration Date | 02/11/2015
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Last Update Date | 02/11/2015
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Provider Practice Location Address
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Address Line | 2826 OLD LEE HWY STE 330
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City | FAIRFAX
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State | VA
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Zip | 22031-4323
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Country | US
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Telephone | 703-457-9991
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Fax |
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Provider Business Mailing Address
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Address Line | 2826 OLD LEE HWY STE 330
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City | FAIRFAX
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State | VA
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Zip | 22031-4323
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Country | US
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Telephone | 703-457-9991
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NAVIN SINGH
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Credential | MD
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Telephone | 703-457-9991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 0101231876
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License Number State | VA
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