Provider Demographics
NPI:1699227942
Name:HEMATOLOGY ONCOLOGY CARE OF NORTHERN VIRGINIA
Entity Type:Organization
Organization Name:HEMATOLOGY ONCOLOGY CARE OF NORTHERN VIRGINIA
Other - Org Name:PRIMARY CARE OF WOODBRIDGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAVEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-698-9400
Mailing Address - Street 1:1900 OPITZ BLVD
Mailing Address - Street 2:SUITE E & F
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3320
Mailing Address - Country:US
Mailing Address - Phone:703-494-1133
Mailing Address - Fax:703-497-4497
Practice Address - Street 1:1900 OPITZ BLVD
Practice Address - Street 2:SUITE E & F
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3320
Practice Address - Country:US
Practice Address - Phone:703-490-3997
Practice Address - Fax:703-698-9403
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEMATOLOGY ONCOLOGY CARE OF NORTHERN VIRGINIA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-11-02
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101251504261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care