Provider Demographics
NPI:1417192261
Name:PARKWAY PEDIATRICS
Entity type:Organization
Organization Name:PARKWAY PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:
Authorized Official - Last Name:QUAYE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-230-7201
Mailing Address - Street 1:464 HERNDON PKWY
Mailing Address - Street 2:SUITE # 117
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-5290
Mailing Address - Country:US
Mailing Address - Phone:703-230-7201
Mailing Address - Fax:703-230-7204
Practice Address - Street 1:464 HERNDON PKWY
Practice Address - Street 2:SUITE # 117
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-5290
Practice Address - Country:US
Practice Address - Phone:703-230-7201
Practice Address - Fax:703-230-7204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101043188261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care