1881930253 NPI number — ARLINGTON PEDIATRIC CENTER

Table of content: (NPI 1881930253)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881930253 NPI number — ARLINGTON PEDIATRIC CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARLINGTON PEDIATRIC CENTER
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:
1881930253
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/12/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 S CARLIN SPRINGS RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22204-1044
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-271-8800
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 S CARLIN SPRINGS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22204-1044
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-271-8800
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/12/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PAZ-SOLDAN
Authorized Official First Name:
GONZALO
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
703-271-8109

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  0904001756 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0855X , with the licence number: 0904001756 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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