| Lifetime Internal Medicine, Pllc | |
|
2579 John Milton Dr Ste 300 Herndon VA 20171-2500 | |
| (703) 828-0799 | |
| (571) 525-2963 |
| Full Name | Lifetime Internal Medicine, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2579 John Milton Dr Ste 300, Herndon, Virginia |
| Authorized Official Name and Position | Shalini Goyal Kaneriya (PHYSICIAN, OWNER) |
| Authorized Official Contact | 7038280799 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifetime Internal Medicine, Pllc 2579 John Milton Dr Ste 300 Herndon VA 20171-2500 Ph: (703) 828-0799 | Lifetime Internal Medicine, Pllc 2579 John Milton Dr Ste 300 Herndon VA 20171-2500 Ph: (703) 828-0799 |
| NPI Number | 1346715141 |
|---|---|
| Provider Enumeration Date | 10/08/2018 |
| Last Update Date | 10/02/2019 |
| Medicare PECOS PAC ID | 6608111828 |
|---|---|
| Medicare Enrollment ID | O20181217001892 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346715141 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Shalini G Kaneriya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699833400 PECOS PAC ID: 9032175088 Enrollment ID: I20060405000140 |
| Provider Name | Julia Takafuji Lim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962492793 PECOS PAC ID: 6103962634 Enrollment ID: I20111031000618 |
| Provider Name | Ira C. Marathe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861585374 PECOS PAC ID: 6204098239 Enrollment ID: I20120508000596 |
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