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Individual

GEMIMA M VENGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
8357 LEESBURG PIKE, VIENNA, VA 22182-2493
(571) 899-3237
(571) 899-3238
Mailing address
PO BOX 791775, BALTIMORE, MD 21279-1775
(571) 302-5000
(571) 302-5001

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110009699
VA

Other

Enumeration date
03/07/2024
Last updated
05/07/2026
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