Provider Demographics
NPI:1689854788
Name:VIRGINIA CENTER FOR ALLERGY AND ASTHMA INC.
Entity Type:Organization
Organization Name:VIRGINIA CENTER FOR ALLERGY AND ASTHMA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SIKORA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-670-3900
Mailing Address - Street 1:2296 OPITZ BLVD
Mailing Address - Street 2:UNIT 401
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3347
Mailing Address - Country:US
Mailing Address - Phone:703-670-3900
Mailing Address - Fax:703-670-6675
Practice Address - Street 1:2296 OPITZ BLVD
Practice Address - Street 2:UNIT 401
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3347
Practice Address - Country:US
Practice Address - Phone:703-670-3900
Practice Address - Fax:703-670-6675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC09180Medicare PIN