Provider Demographics
NPI:1225209018
Name:ABOUT CARE OBGYN ASSOCIATES PC
Entity type:Organization
Organization Name:ABOUT CARE OBGYN ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN PRESIDENT OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LILLIAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DECOSIMO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-222-8600
Mailing Address - Street 1:6134 REDWOOD SQUARE CENTER
Mailing Address - Street 2:UNIT 101
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120
Mailing Address - Country:US
Mailing Address - Phone:703-222-8600
Mailing Address - Fax:703-222-8972
Practice Address - Street 1:6134 REDWOOD SQUARE CENTER
Practice Address - Street 2:UNIT 101
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20120
Practice Address - Country:US
Practice Address - Phone:703-222-8600
Practice Address - Fax:703-222-8972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101053044207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty