NPI 1255791448

Dermatology Associates of Northern Virginia

Organisation Preferred Provider Organization Chantilly, VA

Practice location

Address: 25055 Riding Plz Suite 230, Chantilly, VA 20152-5917
Phone: (703) 222-2773
Fax: (703) 222-6093
Mailing address: 13880 Braddock Rd STE 301, Centreville, VA 20121-2462

Authorised official

Name: Anita June Neely
Title: Administrator
Phone: (703) 222-2773

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 0101047432 (VA)

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Registry record

NPI: 1255791448
Entity type: Organization
NPI issued: 1 Mar 2016
Record last updated: 1 Mar 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.