Provider Demographics
NPI:1871787002
Name:ALLERGY AND ASTHMA ASSOCIATES P.C.
Entity type:Organization
Organization Name:ALLERGY AND ASTHMA ASSOCIATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCREYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-430-0833
Mailing Address - Street 1:6888 ELM ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3894
Mailing Address - Country:US
Mailing Address - Phone:703-430-0833
Mailing Address - Fax:703-430-6073
Practice Address - Street 1:6888 ELM ST
Practice Address - Street 2:SUITE 301
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3894
Practice Address - Country:US
Practice Address - Phone:703-430-0833
Practice Address - Fax:703-430-6073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101042243174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G00221Medicare UPIN