Provider Demographics
NPI:1043211006
Name:MEDICAL ONCOLOGY AND HEMATOLOGY ASSOC OF NORTHERN VIRGINIA
Entity Type:Organization
Organization Name:MEDICAL ONCOLOGY AND HEMATOLOGY ASSOC OF NORTHERN VIRGINIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHAFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-207-0733
Mailing Address - Street 1:8501 ARLINGTON BLVD
Mailing Address - Street 2:SUITE 340
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4617
Mailing Address - Country:US
Mailing Address - Phone:703-207-0733
Mailing Address - Fax:703-207-0736
Practice Address - Street 1:8501 ARLINGTON BLVD
Practice Address - Street 2:SUITE 340
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4617
Practice Address - Country:US
Practice Address - Phone:703-207-0733
Practice Address - Fax:703-207-0736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA681563Medicare ID - Type Unspecified