Provider Demographics
NPI:1205560711
Name:ALEDADE CARE SOLUTIONS OF VIRGINIA
Entity type:Organization
Organization Name:ALEDADE CARE SOLUTIONS OF VIRGINIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:KOCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-475-3703
Mailing Address - Street 1:8609 WESTWOOD CENTER DR STE 110
Mailing Address - Street 2:
Mailing Address - City:TYSONS CORNER
Mailing Address - State:VA
Mailing Address - Zip Code:22182-7525
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4550 MONTGOMERY AVE STE 950N
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3339
Practice Address - Country:US
Practice Address - Phone:571-405-9158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALEDADE CARE SOLUTIONS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-11
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty