DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

PEDIATRIC PRACTICE,PC

Deactivated Organization

PEDIATRIC PRACTICE,PC is a Pediatrics organization located in MANASSAS, Virginia. NPI 1205034659 is deactivated in the NPPES registry. Verify at CMS.

Pediatrics · MANASSAS, VA

This NPI has been deactivated. The record was deactivated on February 27, 2020. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number
1205034659
Provider Type
Organization
NPI Issued
Jul 6, 2007 (12.644808743169 yrs)
Last Updated
Apr 19, 2024
Deactivated
Feb 27, 2020
License
0101222057 (VA)

Practice Information

Address
8600 ROLLING RD STE 100
MANASSAS, VA, 201103868
Browse VA providers · Browse ZIP 20110
Phone
7033613870
Fax
7033613871
Primary Specialty
Pediatrics
208000000X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.