Organization
NCG CHANTILLY LLC
Active
Other names
NCP Chantilly, Physicians Dialysis Chantilly
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN JEGER (VICE PRESIDENT)
(305) 651-3261
Entity
Organization
Contact information
Practice address
14595 AVION PKWY STE 1000, CHANTILLY, VA 20151-1122
(571) 982-6100
(703) 870-7690
Mailing address
19559 NE 10TH AVE, MIAMI, FL 33179-3501
(305) 651-3261
(305) 651-2961
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
11/06/2014
Last updated
03/26/2020
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