| Leonora T Burger, Pc | |
|
5112 Blue Ridge Ave Annandale VA 22003-5503 | |
| (703) 941-4862 | |
| Not Available |
| Full Name | Leonora T Burger, Pc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 5112 Blue Ridge Ave, Annandale, Virginia |
| Authorized Official Name and Position | Leonora T Burger (MSW, LCSW) |
| Authorized Official Contact | 7039414862 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Leonora T Burger, Pc 5112 Blue Ridge Ave Annandale VA 22003-5503 Ph: (703) 941-4862 | Leonora T Burger, Pc 5112 Blue Ridge Ave Annandale VA 22003-5503 Ph: (703) 941-4862 |
| NPI Number | 1093085086 |
|---|---|
| Provider Enumeration Date | 01/06/2012 |
| Last Update Date | 01/06/2012 |
| Medicare PECOS PAC ID | 9032379987 |
|---|---|
| Medicare Enrollment ID | O20120329000800 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093085086 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0904000211 (Virginia) | Primary |
| Provider Name | Leonora T Burger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952483521 PECOS PAC ID: 9931369899 Enrollment ID: I20120329000844 |
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