Provider Demographics
NPI:1811934359
Name:RAPPAHANNOCK PEDIATRIC ASSOCIATES, P.C.
Entity type:Organization
Organization Name:RAPPAHANNOCK PEDIATRIC ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:AARONSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-899-3440
Mailing Address - Street 1:200 EXECUTIVE CENTER PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3107
Mailing Address - Country:US
Mailing Address - Phone:540-899-3440
Mailing Address - Fax:
Practice Address - Street 1:200 EXECUTIVE CENTER PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3107
Practice Address - Country:US
Practice Address - Phone:540-899-3440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101038304208000000X
VA0024167200363LP0200X
VA0024076917363LF0000X
VA0024100683363LP0200X
VA0024077452363LP0200X
VA0024140447363LP0200X
VA0101027990208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC09316Medicare PIN