| Prized Health Pllc | |
|
1800 Town Center Dr Ste 311 Reston VA 20190-3239 | |
| (703) 755-0634 | |
| Not Available |
| Full Name | Prized Health Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1800 Town Center Dr Ste 311, Reston, Virginia |
| Authorized Official Name and Position | Morayo Olufunso Omojokun (PHYSICIAN) |
| Authorized Official Contact | 7037550634 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prized Health Pllc Po Box 1293 Mc Lean VA 22101-1293 Ph: () - | Prized Health Pllc 1800 Town Center Dr Ste 311 Reston VA 20190-3239 Ph: (703) 755-0634 |
| NPI Number | 1871262923 |
|---|---|
| Provider Enumeration Date | 09/12/2021 |
| Last Update Date | 09/12/2021 |
| Medicare PECOS PAC ID | 5092105072 |
|---|---|
| Medicare Enrollment ID | O20211206002456 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871262923 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Morayo O Omojokun |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700887486 PECOS PAC ID: 9638104771 Enrollment ID: I20180413001314 |
| Provider Name | Marisa Konishi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649945593 PECOS PAC ID: 4688072424 Enrollment ID: I20211209000010 |
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