| Family Practice And Pediatrics | |
|
100 Elden Street Suite 14 Herndon VA 20170 | |
| (703) 471-7733 | |
| (703) 471-7733 |
| Full Name | Family Practice And Pediatrics |
|---|---|
| Speciality | Pediatrics |
| Location | 100 Elden Street, Herndon, Virginia |
| Authorized Official Name and Position | Rohini Wijetilleke (MD PC) |
| Authorized Official Contact | 7034717733 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Practice And Pediatrics 100 Elden Street Suite 14 Herndon VA 20170 Ph: (703) 471-7733 | Family Practice And Pediatrics 100 Elden Street Suite 14 Herndon VA 20170 Ph: (703) 471-7733 |
| NPI Number | 1942215330 |
|---|---|
| Provider Enumeration Date | 07/31/2006 |
| Last Update Date | 11/29/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942215330 | NPI | - | NPPES |
| 210923 | Other | BLUE CROSS BS | |
| 5618410 | Medicaid | VA | |
| 281178 | Other | AMERIGROUP | |
| 6711324 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 35528 (Virginia) | Secondary |
| 208000000X | Pediatrics | 35528 (Virginia) | Primary |
Medical Response Partners, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13530 Dulles Technology Dr Ste 500, Herndon, VA 20171 Phone: 607-821-9124 | |
Healthcar, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2109 Highcourt Ln Apt 103, Herndon, VA 20170 Phone: 571-239-1139 | |
Nova Health Management & Research Group, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13505 Dulles Technology Dr, Suite 1a, Herndon, VA 20171 Phone: 703-404-5905 Fax: 703-421-1099 | |
Oliver Pain Relief And Rehab Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1041 Sterling Rd Ste 106, Herndon, VA 20170 Phone: 703-904-8528 Fax: 703-904-8529 | |
Kyss Med Spa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 203 Elden St Ste 304, Herndon, VA 20170 Phone: 703-463-9620 | |
Longview International Technology Solutions, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12930 Worldgate Dr Ste 300, Herndon, VA 20170 Phone: 412-629-0180 | |
Dulles Family Medicine P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 504 Elden St # 3, Herndon, VA 20170 Phone: 703-471-0800 Fax: 703-471-1332 |