Provider Demographics
NPI:1326412735
Name:YU, VERONIQUE (PA-C, RD)
Entity Type:Individual
Prefix:
First Name:VERONIQUE
Middle Name:
Last Name:YU
Suffix:
Gender:F
Credentials:PA-C, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2070 CHAIN BRIDGE RD STE 150
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2598
Mailing Address - Country:US
Mailing Address - Phone:703-383-4836
Mailing Address - Fax:
Practice Address - Street 1:9401 ROUTE 29 STE 400
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-1847
Practice Address - Country:US
Practice Address - Phone:703-383-4836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-23
Last Update Date:2024-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
VA0110-008318363A00000X
MDDX3872133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered