Provider Demographics
NPI:1578140968
Name:HEALE MEDICAL LLC
Entity Type:Organization
Organization Name:HEALE MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORISED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ADITYA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUBEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:571-367-0000
Mailing Address - Street 1:8300 BOONE BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2671
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8300 BOONE BLVD STE 150
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2671
Practice Address - Country:US
Practice Address - Phone:917-379-7365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty