BRANDON AVENUE PEDIATRICS


Address: 6126 Brandon Ave, Springfield, VA 22150-2610
Phone: 5718306337

BRANDON AVENUE PEDIATRICS (NPI# 1215334941) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1215334941
Entity Type Organization
Organization Name BRANDON AVENUE PEDIATRICS
Practice Address 6126 Brandon Ave
Springfield
VA 22150-2610
Mailing Address 6126 Brandon Ave
Springfield
VA 22150
Practice Telephone 5718306337
Mailing Telephone 5718306337
Enumeration Date 2014-11-24
Last Update Date 2014-11-24
Authorized Official Name SAAD O. AL-HARIRI (PRESIDENT)
Authorized Official Telephone 5718306337
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 174400000X Specialist 0101051396 VA Other Service Providers

Office Location

Street Address 6126 BRANDON AVE
City SPRINGFIELD
State VA
Zip Code 22150-2610

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Taxonomy Information

Taxonomy Code 174400000X
Grouping Other Service Providers
Classification Specialist

Taxonomy Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974.

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1659771350 Ronnie L. Jackson Md Specialist 496 Northcrest Dr, Springfield, TN 37172-3972 2014-08-29
1659781136 Ashley Foucha Specialist 1342 E Primrose St Ste A, Springfield, MO 65804-4224 2014-05-05
1225452881 Elizabeth Creps Specialist 1623 21st St Ste B, Springfield, OR 97477-3417 2014-02-18
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Competitor

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City SPRINGFIELD
Zip Code 22150

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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