MEDICARE: UNITY FAMILY HEALTH CENTER PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1083504310
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITY FAMILY HEALTH CENTER PLLC

Provider Business Mailing Address
First Line	:	4504 GASTON ST
Second Line	:
City	:	CHANTILLY
State	:	VA
Zip	:	20151-2244
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	850 WALNUT BOTTOM RD STE 101B
Second Line	:
City	:	CARLISLE
State	:	PA
Zip	:	17013-3615
Country	:	US
Telephone Number	:	202-702-1642
Fax Number	:

Authorized Official
Title or Position	:	ADMINSTRATOR
Name	:	ASHISH SANGROULA
Credential	:
Telephone Number	:	202-702-1642

Provider Enumeration Date	:	07/08/2025
Last Update Date	:	12/05/2025

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