Provider Demographics
NPI:1760489231
Name:ARLINGTON OB-GYN, PC
Entity Type:Organization
Organization Name:ARLINGTON OB-GYN, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEEPALI
Authorized Official - Middle Name:
Authorized Official - Last Name:KOTHARY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-528-4211
Mailing Address - Street 1:PO BOX 1400
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22038-1400
Mailing Address - Country:US
Mailing Address - Phone:703-383-9543
Mailing Address - Fax:703-383-9532
Practice Address - Street 1:1715 N GEORGE MASON DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3662
Practice Address - Country:US
Practice Address - Phone:703-528-4211
Practice Address - Fax:703-528-4233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101234648207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
I26336Medicare UPIN
491965Medicare ID - Type UnspecifiedMEDICARE