Provider Demographics
NPI:1902454366
Name:LAINOFF, MEGHAN A (PA-C)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:A
Last Name:LAINOFF
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:ANN
Other - Last Name:NEARY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:20 W CUSTIS AVE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22301-1522
Mailing Address - Country:US
Mailing Address - Phone:703-470-6034
Mailing Address - Fax:
Practice Address - Street 1:4225 ALTAMONT PL STE 3
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695-3064
Practice Address - Country:US
Practice Address - Phone:301-374-9511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-29
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110007575363A00000X
MDC0009361363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant