Provider Demographics
NPI:1174199699
Name:THE WATERGATE AND BURKE ALLERGY & ASTHMA CENTERS, PLLC
Entity Type:Organization
Organization Name:THE WATERGATE AND BURKE ALLERGY & ASTHMA CENTERS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:TALAL
Authorized Official - Middle Name:M
Authorized Official - Last Name:NSOULI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-580-6028
Mailing Address - Street 1:2600 VIRGINIA AVE NW STE 508
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1946
Mailing Address - Country:US
Mailing Address - Phone:301-580-6028
Mailing Address - Fax:
Practice Address - Street 1:2600 VIRGINIA AVE NW STE 508
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1946
Practice Address - Country:US
Practice Address - Phone:301-580-6028
Practice Address - Fax:202-342-1855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty