Springfield Primary Care | |
6128 Brandon Ave Ste 225 Springfield VA 22150-2640 | |
(703) 936-9099 | |
Not Available |
Full Name | Springfield Primary Care |
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Speciality | Clinic/Center |
Location | 6128 Brandon Ave Ste 225, Springfield, Virginia |
Authorized Official Name and Position | Janice Sadaya-conda (OWNER) |
Authorized Official Contact | 7039369099 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Springfield Primary Care 6412 Brandon Ave # 723 Springfield VA 22150-2513 Ph: () - | Springfield Primary Care 6128 Brandon Ave Ste 225 Springfield VA 22150-2640 Ph: (703) 936-9099 |
NPI Number | 1730790874 |
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Provider Enumeration Date | 08/12/2020 |
Last Update Date | 08/25/2020 |
Medicare PECOS PAC ID | 2668883851 |
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Medicare Enrollment ID | O20201119000062 |
Identifier | Type | State | Issuer |
---|---|---|---|
1730790874 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Janice Garcia Sadaya-conda |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1538161062 PECOS PAC ID: 8527182328 Enrollment ID: I20100831000833 |
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