Provider Demographics
NPI:1013182153
Name:CARDIAC, VASCULAR & THORACIC SURGERY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:CARDIAC, VASCULAR & THORACIC SURGERY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DONATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-280-5860
Mailing Address - Street 1:2921 TELESTAR CT
Mailing Address - Street 2:SUITE 140
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1205
Mailing Address - Country:US
Mailing Address - Phone:703-280-5858
Mailing Address - Fax:703-849-0874
Practice Address - Street 1:384 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-3006
Practice Address - Country:US
Practice Address - Phone:703-280-5858
Practice Address - Fax:703-849-0874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0840359208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty