Provider Demographics
NPI:1780704551
Name:FARLEY-PINA, JULIE LEE (MD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:LEE
Last Name:FARLEY-PINA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 TOWN CENTER DR
Mailing Address - Street 2:SUITE 212
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-3215
Mailing Address - Country:US
Mailing Address - Phone:703-435-2227
Mailing Address - Fax:703-435-7856
Practice Address - Street 1:1800 TOWN CENTER DR
Practice Address - Street 2:SUITE 212
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3215
Practice Address - Country:US
Practice Address - Phone:703-435-2227
Practice Address - Fax:703-435-7856
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101058956207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine