Provider Demographics
NPI:1134254154
Name:MANASSAS FAMILY MEDICINE PLC
Entity type:Organization
Organization Name:MANASSAS FAMILY MEDICINE PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:J
Authorized Official - Last Name:BUCHINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-368-1182
Mailing Address - Street 1:8691 STONEWALL RD
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4510
Mailing Address - Country:US
Mailing Address - Phone:703-368-1182
Mailing Address - Fax:703-368-0247
Practice Address - Street 1:8691 STONEWALL RD
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4510
Practice Address - Country:US
Practice Address - Phone:703-368-1182
Practice Address - Fax:703-368-0247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101034986207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0800055000Medicare ID - Type UnspecifiedVINCENT BUCHINSKY MEDICAR
VAB08003Medicare UPIN