Children'S Multispecialty Clinic, PLC

Organization Active NPI Specialist · Herndon, VA

NPI 1700217684 · NPPES record last updated Mar 31, 2014

Key facts

NPI
1700217684
Entity type
Organization (NPI type 2)
Primary specialty
Specialist 174400000X
License
0101058336 (VA)
Legal business name
CHILDREN'S MULTISPECIALTY CLINIC, PLC
Practice address
171 Elden Street, Ste. 2C4
Herndon, VA 20170
Phone
(571) 612-2606
Fax
(703) 481-5804
NPI assigned
Dec 3, 2013
Organization subpart
No

Authorized official

Name
Hasan I. Abdallah., M.D.
Title
Medical Director
Phone
(703) 481-5801

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

19465 Deerfield Ave
Ste 310
Leesburg, VA 20176
Phone (703) 724-0410

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist
Group: 193200000X MULTI-SPECIALTY GROUP
174400000X 0101058336 VA Yes

Addresses

Primary practice location

171 Elden Street, Ste. 2C4
Herndon, VA 20170

Mailing address

P.O. Box 10066
MC Lean, VA 22102
Phone (571) 612-2600

Other providers in Herndon, VA

All providers in Herndon, VA · Specialist in Virginia

Sources for this page

Verify at the official NPI Registry.