1770772816 NPI number — WASHINGTON NEUROSURGICAL ASSOCIATES, P. C.

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 1770772816 NPI number — WASHINGTON NEUROSURGICAL ASSOCIATES, P. C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WASHINGTON NEUROSURGICAL ASSOCIATES, P. C.
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:
1770772816
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/23/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5215 LOUGHBORO ROAD, NW
Provider Second Line Business Mailing Address:
SUITE 510
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20016
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-966-6300
Provider Business Mailing Address Fax Number:
202-364-4362

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5215 LOUGHBORO ROAD, NW
Provider Second Line Business Practice Location Address:
SUITE 510
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-966-6300
Provider Business Practice Location Address Fax Number:
202-364-4362
Provider Enumeration Date:
10/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CONNORS
Authorized Official First Name:
DIANA
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
PRACTICE MANAGER
Authorized Official Telephone Number:
202-966-6300

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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