Organization
FAIRFAX NEONATAL ASSOCIATES, LLC
Active
Other names
Fairfax Neonatal Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY EDWARD BENGSTON (EVP, COO)
(703) 289-1422
Entity
Organization
Contact information
Practice address
3060 WILLIAMS DRIVE, SUITE 520, FAIRFAX, VA 22031-4648
(703) 289-1400
(703) 289-1414
Mailing address
3060 WILLIAMS DRIVE, SUITE 520, FAIRFAX, VA 22031-4648
(703) 289-1400
(703) 289-1414
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
—
2080P0214X
Pediatric Pulmonology Physician
—
—
Other
Enumeration date
04/27/2006
Last updated
05/21/2025
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