Organization
PEDIATRIC PRACTICE,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANJAY LAMBA MD (PRESIDENT)
(703) 361-3870
Entity
Organization
Contact information
Practice address
8600 ROLLING RD STE 100, MANASSAS, VA 20110-3868
(703) 361-3870
(703) 361-3871
Mailing address
5131 PLEASANT FOREST DR, CENTREVILLE, VA 20120-1249
(703) 803-3282
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101222057
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006702015
—
VA
Enumeration date
07/06/2007
Last updated
04/19/2024
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