1700259520 NPI number — VIRGINIA ONCOLOGY ASSOCIATES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700259520 NPI number — VIRGINIA ONCOLOGY ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VIRGINIA ONCOLOGY ASSOCIATES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700259520
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/02/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5900 LAKE WRIGHT DR
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
NORFOLK
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23502-1871
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-213-5683
Provider Business Mailing Address Fax Number:
757-213-5762

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2790 GODWIN BLVD
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
SUFFOLK
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23434-8151
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-539-0670
Provider Business Practice Location Address Fax Number:
757-539-1062
Provider Enumeration Date:
11/02/2015

Additional Information

Authorized Official

Authorized Official Last Name:
ALBERICO
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
757-466-8683

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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