Provider Demographics
NPI:1477610996
Name:PEDIATRIC CARDIOLOGY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:PEDIATRIC CARDIOLOGY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEYMOUR
Authorized Official - Middle Name:I
Authorized Official - Last Name:HEPNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-573-0504
Mailing Address - Street 1:8316 ARLINGTON BLVD
Mailing Address - Street 2:SUITE 610
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-5207
Mailing Address - Country:US
Mailing Address - Phone:703-573-0504
Mailing Address - Fax:703-573-4856
Practice Address - Street 1:8316 ARLINGTON BLVD
Practice Address - Street 2:SUITE 610
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-5207
Practice Address - Country:US
Practice Address - Phone:703-573-0504
Practice Address - Fax:703-573-4856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101027389174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty