Fairfax Tms Pllc | |
9020f Lorton Station Blvd Ste 123 Lorton VA 22079-4799 | |
(571) 477-0380 | |
Not Available |
Full Name | Fairfax Tms Pllc |
---|---|
Speciality | Clinic/Center |
Location | 9020f Lorton Station Blvd Ste 123, Lorton, Virginia |
Authorized Official Name and Position | Adnan Mahmood Durrani (CEO) |
Authorized Official Contact | 2023158210 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Fairfax Tms Pllc 9500 Peniwill Dr Lorton VA 22079-3457 Ph: (202) 315-8210 | Fairfax Tms Pllc 9020f Lorton Station Blvd Ste 123 Lorton VA 22079-4799 Ph: (571) 477-0380 |
NPI Number | 1356026587 |
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Provider Enumeration Date | 06/15/2023 |
Last Update Date | 06/15/2023 |
Certification Date | 06/15/2023 |
Medicare PECOS PAC ID | 7315396538 |
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Medicare Enrollment ID | O20231213003591 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356026587 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
Provider Name | Adnan Durrani |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1609256767 PECOS PAC ID: 5294093373 Enrollment ID: I20171219000440 |
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