Organization
ABOUT CARE GYN ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LILLIAN DECOSIMO M.D. (PHYSICIAN , SOLE MEMBER OWNER)
(703) 859-5225
Entity
Organization
Contact information
Practice address
3650 JOSEPH SIEWICK DR, SUITE 309, FAIRFAX, VA 22033-1710
(703) 859-5225
(844) 898-2182
Mailing address
PO BOX 220925, CHANTILLY, VA 20153-0925
(703) 859-5225
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
0101053044
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6201547
—
VA
Enumeration date
12/19/2016
Last updated
01/09/2017
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