Organization
ALEXANDRIA LAKE RIDGE PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN HOFFER (CLINICAL ADMINISTRTOR)
(703) 436-1200
Entity
Organization
Contact information
Practice address
1500 N BEAUREGARD ST STE 200, ALEXANDRIA, VA 22311-1700
(703) 436-1200
(703) 499-9670
Mailing address
1500 N BEAUREGARD ST STE 200, ALEXANDRIA, VA 22311-1700
(703) 436-1200
(703) 499-9670
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
101038289
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010077036
—
VA
05
—
6704999
—
VA
05
—
6719694
—
VA
05
—
6721001
—
VA
05
—
6733816
—
VA
05
—
6737935
—
VA
05
—
6738206
—
VA
05
—
6738214
—
VA
05
—
6792896
—
VA
Enumeration date
06/19/2006
Last updated
04/14/2022
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