| Northern Virginia Neurology, Pllc | |
|
1958 Opitz Blvd Woodbridge VA 22191-3304 | |
| (703) 494-1111 | |
| (703) 494-1141 |
| Full Name | Northern Virginia Neurology, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1958 Opitz Blvd, Woodbridge, Virginia |
| Authorized Official Name and Position | Maher Loutfi (OWNER) |
| Authorized Official Contact | 7034941111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Virginia Neurology, Pllc 1958 Opitz Blvd Woodbridge VA 22191-3304 Ph: (703) 494-1111 | Northern Virginia Neurology, Pllc 1958 Opitz Blvd Woodbridge VA 22191-3304 Ph: (703) 494-1111 |
| NPI Number | 1922522341 |
|---|---|
| Provider Enumeration Date | 07/27/2017 |
| Last Update Date | 01/25/2024 |
| Certification Date | 01/25/2024 |
| Medicare PECOS PAC ID | 7719253046 |
|---|---|
| Medicare Enrollment ID | O20171031003174 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922522341 | NPI | - | NPPES |
| 133636516 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 0101249650 (Virginia) | Primary |
| Provider Name | Maher Loutfi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336365162 PECOS PAC ID: 0143498964 Enrollment ID: I20110722000063 |
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