Provider Demographics
NPI:1184878902
Name:ASCENSAO, VIVIAN PEREYRA (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:PEREYRA
Last Name:ASCENSAO
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:VIVIAN
Other - Middle Name:
Other - Last Name:PEREYRA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:7346 HOOKING RD
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-2718
Mailing Address - Country:US
Mailing Address - Phone:703-893-6896
Mailing Address - Fax:
Practice Address - Street 1:13001 WORLDGATE DR
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4374
Practice Address - Country:US
Practice Address - Phone:703-230-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-06
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012488002083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine