Provider Demographics
NPI:1548351802
Name:OB-GYN ASSOCIATES OF N VA LTD
Entity type:Organization
Organization Name:OB-GYN ASSOCIATES OF N VA LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DARIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:LEPISKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-719-0382
Mailing Address - Street 1:6355 WALKER LN
Mailing Address - Street 2:SUITE 408
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-3245
Mailing Address - Country:US
Mailing Address - Phone:703-719-5901
Mailing Address - Fax:703-719-9629
Practice Address - Street 1:6355 WALKER LN
Practice Address - Street 2:SUITE 408
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-3245
Practice Address - Country:US
Practice Address - Phone:703-719-5901
Practice Address - Fax:703-719-9629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA=========OtherTAX ID
TX409891Medicare PIN