MEDICARE: JP GRP 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	202K00000X	Phlebology Physician

General Provider Information

NPI Number	:	1871249029
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JP GRP LLC

Provider Business Mailing Address
First Line	:	7412 MARC DR
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22042-3612
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7412 MARC DR
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22042-3612
Country	:	US
Telephone Number	:	703-853-7147
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. JATINDERPAL SAYAL
Credential	:
Telephone Number	:	703-853-7147

Provider Enumeration Date	:	02/25/2022
Last Update Date	:	02/25/2022

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Directions to “JP GRP LLC ” Practice Location

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