Accredited Allergy Center of Springfield, LTD
Organization Active NPI Specialist · Springfield, VA
NPI 1639371990 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1639371990
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- 0101237445 (VA)
- Legal business name
- ACCREDITED ALLERGY CENTER OF SPRINGFIELD, LTD
- Practice address
- 8134 Old Keene Mill Rd Ste 301
Springfield, VA 22152-1849 - Phone
- (703) 569-1913
- Fax
- (703) 569-6035
- NPI assigned
- May 31, 2007
- Organization subpart
- No
Authorized official
- Name
- Teresa Teague
- Title
- Practice Administrator
- Phone
- (703) 569-1913
Practitioners 3
-
Laura M Gesicki-Wood, M.D.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | 0101237445 | VA | Yes |
Addresses
Primary practice location
8134 Old Keene Mill Rd Ste 301
Springfield, VA 22152-1849
Mailing address
8134 Old Keene Mill Rd Ste 301
Springfield, VA 22152-1849
Phone (703) 569-1913
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10191734 | Medicaid | VA |
Other providers in Springfield, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.