| Refreva LLC | |
|
1035 Sterling Rd Ste 104 Herndon VA 20170-3838 | |
| (571) 363-5182 | |
| Not Available |
| Full Name | Refreva LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 1035 Sterling Rd Ste 104, Herndon, Virginia |
| Authorized Official Name and Position | Salman Khan (MANAGING PARTNER) |
| Authorized Official Contact | 7867885080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Refreva LLC 1035 Sterling Rd Ste 104 Herndon VA 20170-3838 Ph: (571) 363-5182 | Refreva LLC 1035 Sterling Rd Ste 104 Herndon VA 20170-3838 Ph: (571) 363-5182 |
| NPI Number | 1326851064 |
|---|---|
| Provider Enumeration Date | 01/28/2025 |
| Last Update Date | 06/20/2025 |
| Certification Date | 06/20/2025 |
| Medicare PECOS PAC ID | 8921511247 |
|---|---|
| Medicare Enrollment ID | O20250701000144 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326851064 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Han Tonthat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801897335 PECOS PAC ID: 3779684345 Enrollment ID: I20070726000330 |
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