Provider Demographics
NPI:1275749277
Name:ALLERGY ASSOCIATES OF N. VIRGINIA, PLLC
Entity Type:Organization
Organization Name:ALLERGY ASSOCIATES OF N. VIRGINIA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:JOO
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-558-6040
Mailing Address - Street 1:1715 N GEORGE MASON DR
Mailing Address - Street 2:SUITE 502
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3609
Mailing Address - Country:US
Mailing Address - Phone:703-558-6040
Mailing Address - Fax:703-558-6042
Practice Address - Street 1:1715 N GEORGE MASON DR
Practice Address - Street 2:SUITE 502
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3609
Practice Address - Country:US
Practice Address - Phone:703-558-6040
Practice Address - Fax:703-558-6042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101239697261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7993496OtherAETNA
VA297010OtherANTHEM BCBS
VA5147476ML2OtherUNITED HEALTHCARE
VA9301453OtherPHCS
VA1613994OtherAETNA HMO
VA2547291OtherCIGNA
VA762237OtherNCPPO
MD0210OtherCAREFIRST BCBS