Organization
INOVA FAIRFAX HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA THONG (CLINICAL PSYCHIATRIC LIAISON)
(703) 776-3491
Entity
Organization
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 776-3491
Mailing address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 776-3491
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
0904006012
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4900634
—
VA
Enumeration date
02/22/2008
Last updated
02/22/2008
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