Provider Demographics
NPI:1023688827
Name:EVENBEAM NEUROPALLIATIVE CARE, LLC
Entity type:Organization
Organization Name:EVENBEAM NEUROPALLIATIVE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARRAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DALY
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA
Authorized Official - Phone:540-924-3258
Mailing Address - Street 1:673 POTOMAC STATION DR NE # 605
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-1819
Mailing Address - Country:US
Mailing Address - Phone:540-924-3258
Mailing Address - Fax:856-249-9592
Practice Address - Street 1:7112 BRADDOCK RD
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003
Practice Address - Country:US
Practice Address - Phone:540-924-3258
Practice Address - Fax:856-249-9592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084H0002XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyHospice and Palliative MedicineGroup - Single Specialty