Provider Demographics
NPI:1992881452
Name:FRANCONIA PEDIATRICS & ADOLESCENT CENTER
Entity type:Organization
Organization Name:FRANCONIA PEDIATRICS & ADOLESCENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VASANTHI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHADIVE
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:703-921-0256
Mailing Address - Street 1:6078 FRANCONIA RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-4400
Mailing Address - Country:US
Mailing Address - Phone:703-921-0256
Mailing Address - Fax:
Practice Address - Street 1:6078 FRANCONIA RD
Practice Address - Street 2:SUITE A
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-4400
Practice Address - Country:US
Practice Address - Phone:703-921-0256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231789208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty