Prestige Medical House Call Llc | |
8315 Lee Hwy Ste 202 Fairfax VA 22031-2215 | |
(703) 352-1959 | |
(703) 352-2294 |
Full Name | Prestige Medical House Call Llc |
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Speciality | Internal Medicine |
Location | 8315 Lee Hwy Ste 202, Fairfax, Virginia |
Authorized Official Name and Position | Erwin Cheng (CEO) |
Authorized Official Contact | 7033521959 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Prestige Medical House Call Llc 8315 Lee Hwy Ste 202 Fairfax VA 22031-2215 Ph: (703) 352-1959 | Prestige Medical House Call Llc 8315 Lee Hwy Ste 202 Fairfax VA 22031-2215 Ph: (703) 352-1959 |
NPI Number | 1497316269 |
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Provider Enumeration Date | 06/24/2019 |
Last Update Date | 06/24/2019 |
Medicare PECOS PAC ID | 1658704036 |
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Medicare Enrollment ID | O20191126002130 |
Identifier | Type | State | Issuer |
---|---|---|---|
1497316269 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Christina M Tafe |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235398702 PECOS PAC ID: 7618022799 Enrollment ID: I20090826000555 |
Provider Name | Taffae Mayonette Cadeau |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1295048338 PECOS PAC ID: 2163547217 Enrollment ID: I20140512001208 |
Provider Name | Noelle Pierson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982003091 PECOS PAC ID: 4688992621 Enrollment ID: I20150820009995 |
Provider Name | Kimmala S Roundtree |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1205210788 PECOS PAC ID: 0547576589 Enrollment ID: I20150904001562 |
Provider Name | Sundi Elaina Tate |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497121982 PECOS PAC ID: 6901105964 Enrollment ID: I20160725002451 |
Provider Name | Maura A Constance |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174928238 PECOS PAC ID: 6709172539 Enrollment ID: I20160906000118 |
Provider Name | Evelyne Kingori |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821650177 PECOS PAC ID: 9032544101 Enrollment ID: I20200117001387 |
Provider Name | Anita Dedei Akwetey |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811416423 PECOS PAC ID: 8224463237 Enrollment ID: I20200122001259 |
Provider Name | Sandra L Wright |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598313637 PECOS PAC ID: 5698101970 Enrollment ID: I20200205000129 |
Provider Name | Nasiru Tejan |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720625221 PECOS PAC ID: 4486081197 Enrollment ID: I20200219000137 |
Provider Name | Maria Theresa Lee |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508395245 PECOS PAC ID: 3779911359 Enrollment ID: I20200313000363 |
Provider Name | Tran Le Khuu |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851421556 PECOS PAC ID: 3274680327 Enrollment ID: I20200428000309 |
Provider Name | Apryl Young |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144713926 PECOS PAC ID: 6103159595 Enrollment ID: I20200903000966 |
Provider Name | Suyun Kim |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588060636 PECOS PAC ID: 0547584658 Enrollment ID: I20200916000460 |
Provider Name | Cierra Jade Relyea |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669083416 PECOS PAC ID: 3274952676 Enrollment ID: I20201005002037 |
Provider Name | Carla Tate |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033796065 PECOS PAC ID: 4284042359 Enrollment ID: I20210412000095 |
Provider Name | Jessica Gilleo |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558944959 PECOS PAC ID: 6103225123 Enrollment ID: I20210525001109 |
Provider Name | Stephanie Nicole Kralles |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720671860 PECOS PAC ID: 3476953720 Enrollment ID: I20210610000213 |
Provider Name | Shuyue Yang |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275247512 PECOS PAC ID: 6901277011 Enrollment ID: I20230930000064 |
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