| Sunnyview Neurology Practice | |
|
1860 Town Center Dr Suite 320 Reston VA 20190-5896 | |
| (703) 348-7207 | |
| (703) 435-1844 |
| Full Name | Sunnyview Neurology Practice |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 1860 Town Center Dr, Reston, Virginia |
| Authorized Official Name and Position | Ishtiaq Ahmad (CEO) |
| Authorized Official Contact | 7033487207 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunnyview Neurology Practice 1860 Town Center Dr Suite 320 Reston VA 20190-5896 Ph: (703) 348-7207 | Sunnyview Neurology Practice 1860 Town Center Dr Suite 320 Reston VA 20190-5896 Ph: (703) 348-7207 |
| NPI Number | 1124065487 |
|---|---|
| Provider Enumeration Date | 06/02/2006 |
| Last Update Date | 09/29/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124065487 | NPI | - | NPPES |
| 010358906 | Medicaid | VA | |
| 248660 | Other | VA | BC/BS OF VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 0101230245 (Virginia) | Primary |
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