MEDICARE: VIRGINIA CENTER FOR ALLERGY AND ASTHMA INC.

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	207RA0201X	Allergy & Immunology (Internal Medicine) Physician

General Provider Information

NPI Number	:	1689854788
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIRGINIA CENTER FOR ALLERGY AND ASTHMA INC.

Provider Business Mailing Address
First Line	:	2296 OPITZ BLVD
Second Line	:	UNIT 401
City	:	WOODBRIDGE
State	:	VA
Zip	:	22191-3347
Country	:	US
Telephone Number	:	703-670-3900
Fax Number	:	703-670-6675

Provider Business Practice Location Address
First Line	:	2296 OPITZ BLVD
Second Line	:	UNIT 401
City	:	WOODBRIDGE
State	:	VA
Zip	:	22191-3347
Country	:	US
Telephone Number	:	703-670-3900
Fax Number	:	703-670-6675

Authorized Official
Title or Position	:	PHYSICIAN OWNER
Name	:	ROBERT SIKORA
Credential	:	MD
Telephone Number	:	703-670-3900

Provider Enumeration Date	:	11/07/2007
Last Update Date	:	02/14/2014

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