MEDICARE: HEALING HANDS CENTER LLC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1235759903
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING HANDS CENTER LLC

Provider Business Mailing Address
First Line	:	1964 GALLOWS RD STE 300
Second Line	:
City	:	VIENNA
State	:	VA
Zip	:	22182-3814
Country	:	US
Telephone Number	:	703-712-7199
Fax Number	:	703-712-7015

Provider Business Practice Location Address
First Line	:	14087 RICHMOND HWY STE 101
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22191-2171
Country	:	US
Telephone Number	:	571-300-8000
Fax Number	:	571-300-8001

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	CONSTANTINE CHIENKU
Credential	:	MD
Telephone Number	:	703-712-7199

Provider Enumeration Date	:	04/22/2020
Last Update Date	:	01/17/2025

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Directions to “HEALING HANDS CENTER LLC ” Practice Location

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