Provider Demographics
NPI:1467513275
Name:NORTHERN VIRGINIA ALLERGY AND ASTHMA ASSOCIATES
Entity Type:Organization
Organization Name:NORTHERN VIRGINIA ALLERGY AND ASTHMA ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ALVA
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-534-5500
Mailing Address - Street 1:6305 CASTLE PLACE
Mailing Address - Street 2:SUITE 2D SEVEN CORNERS MEDICAL BUILDING
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-1905
Mailing Address - Country:US
Mailing Address - Phone:703-534-5500
Mailing Address - Fax:703-534-4888
Practice Address - Street 1:6305 CASTLE PLACE
Practice Address - Street 2:SUITE 2D SEVEN CORNERS MEDICAL BUILDING
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-1905
Practice Address - Country:US
Practice Address - Phone:703-534-5500
Practice Address - Fax:703-534-4888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00363253OtherPALMETTO GBA/RAILROAD MEDICARE
VAP00363253OtherPALMETTO GBA/RAILROAD MEDICARE