Organization
FAIRFAX NEONATAL ASSOCIATES, PC
Active
Parent organization
FAIRFAX NEONATAL ASSOCIATES, PC
Other names
Pediatric Lung and Allergy Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAIRFAX NEONATAL ASSOCIATES, PC
Authorized official
CAROLYN HALTERMAN (PROJECT MANAGER)
(703) 289-1448
Entity
Organization
Contact information
Practice address
2730 PROSPERITY AVE STE A, FAIRFAX, VA 22031-4330
(703) 289-1410
Mailing address
2730 PROSPERITY AVE # B, FAIRFAX, VA 22031-4329
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
2080P0214X
Pediatric Pulmonology Physician
Primary
—
—
Other
Enumeration date
06/07/2007
Last updated
04/26/2016
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