| Center For Primary Care & Geriatrics | |
|
7115 Leesburg Pike Ste 211 Falls Church VA 22043-2301 | |
| (703) 532-1111 | |
| (703) 532-3224 |
| Full Name | Center For Primary Care & Geriatrics |
|---|---|
| Speciality | Family Medicine |
| Location | 7115 Leesburg Pike Ste 211, Falls Church, Virginia |
| Authorized Official Name and Position | Cissy Paul Pottanat (OWNER PRESIDENT) |
| Authorized Official Contact | 7035329411 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Primary Care & Geriatrics 6319 Castle Place Suite #3d Falls Church VA 22044-1907 Ph: (703) 532-1111 | Center For Primary Care & Geriatrics 7115 Leesburg Pike Ste 211 Falls Church VA 22043-2301 Ph: (703) 532-1111 |
| NPI Number | 1902973423 |
|---|---|
| Provider Enumeration Date | 11/29/2006 |
| Last Update Date | 05/28/2023 |
| Medicare PECOS PAC ID | 8426109836 |
|---|---|
| Medicare Enrollment ID | O20090625000093 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902973423 | NPI | - | NPPES |
| 5628997 | Medicaid | VA | |
| 287222 | Other | ANTHEM | |
| 49D0222254 | Other | CLIA # | |
| F383001 | Other | CAREFIRST |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101056325 (Virginia) | Primary |
| Provider Name | Cissy Paul Pottanat |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1295802718 PECOS PAC ID: 6709937113 Enrollment ID: I20090625000080 |
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