Provider Demographics
NPI:1053459149
Name:NIRSCHL ORTHOPAEDIC CENTER FOR SPORTSMEDICINE & JOINT RECONSTRUCTION
Entity Type:Organization
Organization Name:NIRSCHL ORTHOPAEDIC CENTER FOR SPORTSMEDICINE & JOINT RECONSTRUCTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:NIRSCHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-525-2200
Mailing Address - Street 1:1715 N GEORGE MASON DR
Mailing Address - Street 2:SUTIE #504
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3609
Mailing Address - Country:US
Mailing Address - Phone:703-525-2200
Mailing Address - Fax:703-522-2603
Practice Address - Street 1:1715 N GEORGE MASON DR
Practice Address - Street 2:SUTIE #504
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3609
Practice Address - Country:US
Practice Address - Phone:703-525-2200
Practice Address - Fax:703-522-2603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC045973Medicare PIN