FAIRFAX NEONATAL ASSOCIATES, PC (NPI# 1700088242) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700088242 |
| Entity Type | Organization |
| Organization Name | FAIRFAX NEONATAL ASSOCIATES, PC |
| Other Organization Name | PEDIATRIC SURGICAL GROUP |
| Practice Address |
2730 Prosperity Ave Ste C Fairfax VA 22031-4329 |
| Mailing Address |
2730 Prosperity Ave # B Fairfax VA 22031-4329 |
| Practice Telephone | 7035602236 |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2016-05-18 |
| Authorized Official Name | CAROLYN HALTERMAN (PROJECT MANAGER) |
| Authorized Official Telephone | 7032891448 |
| Is Organization Subpart | Y |
| Parent Organization Name | FAIRFAX NEONATAL ASSOCIATES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Pediatric Surgical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538362504 | Fairfax Neonatal Associates, PC | Allergy & Immunology | 2730 Prosperity Ave Ste A, Fairfax, VA 22031-4330 | 2007-06-07 |
| Street Address |
2730 PROSPERITY AVE STE C |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22031-4329 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699810036 | Suraiya Kureshi Haider | Pediatrics | 2730 Prosperity Ave, Suite D, Fairfax, VA 22031-4329 | 2007-02-21 |
| 1831528991 | Meghan Glassmacher Cromwell | Nurse Practitioner | 2730 Prosperity Ave, Ste A, Fairfax, VA 22031-4329 | 2013-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902414105 | Su Jung Kang | Dentist | 9661-c Main Street, Fairfax, VA 22031 | 2020-07-14 |
| 1346896347 | Fuling Guo | Acupuncturist | 3013 James St, Fairfax, VA 22031 | 2019-08-15 |
| 1902458797 | Kayla Callister | Psychologist | 2270 Willow Oaks Corporate Drive, Fairfax, VA 22031 | 2019-07-11 |
| 1790349801 | Fairfax Dental Esthetics | Dentist | 9621 Fairfax Blvd., Fairfax, VA 22031 | 2019-04-24 |
| 1417427675 | Kathryn Yen Ho | Speech-Language Pathologist | 8270 Willow Oaks Corporate Drive Suite 2127, Falls Church, VA 22031 | 2018-11-30 |
| 1932681376 | Joanne Towers | Physician Assistant | 3025 Hamaker Court Suite 300, Fairfax, VA 22031 | 2018-09-01 |
| 1790262020 | S Renee Dennis | Nurse Practitioner | 8316 Arlington Blvd Ste 500, Fairfax, VA 22031 | 2018-07-19 |
| 1013493451 | Elizabeth Joan Dwyer | Physician Assistant | 3023 Hamaker Ct., Suite 500, Fairfax, VA 22031 | 2018-07-18 |
| 1316432669 | Delta Pharm LLC | Pharmacy | 8316 Arlington Blvd Ste 100, Fairfax, VA 22031 | 2018-06-28 |
| 1629567656 | Laura Breeden | Acupuncturist | 3846 Lyndhurst Dr Apt 301, Fairfax, Va, VA 22031 | 2018-05-04 |
| Find all providers in zip 22031 | ||||
| Taxonomy Code | 2086S0120X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Pediatric Surgery |
| A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306074323 | Iljana Marjorie Gaffar | Surgery | 2730 Prosperity Ave Ste C, Fairfax, VA 22031 | 2009-06-29 |
| 1811275407 | Bharath Dwaraka Nath | Surgery | 2730 Prosperity Ave Ste C, Fairfax, VA 22031 | 2011-07-29 |
| 1700095916 | Joseph Edmond Hartwich | Surgery | 2730 Prosperity Ave Ste B, Fairfax Neonatal Associates, Fairfax, VA 22031-4324 | 2007-05-22 |
| 1942390836 | Stephen S Kim | Surgery | 2730-c Prosperity Avenue, Fairfax, VA 22031 | 2006-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568063196 | Madeleine Holden Snidow | Surgery | 3760 Reeds Landing Cir, Midlothian, VA 23113-1369 | 2020-11-02 |
| 1649884719 | Amal Y Elkhatib | Surgery | 2914 Myrtlewood Dr, Dumfries, VA 22026-2202 | 2020-09-04 |
| 1215926332 | Richmond Pediatric Surgeons LLC | Surgery | 7115 Jahnke Rd, Richmond, VA 23225-4017 | 2005-10-20 |
| 1811160971 | Daniel E. Levin | Surgery | 1204 W Main St, Charlottesville, VA 22903-2824 | 2008-04-10 |
| 1629192836 | Laura Anne Boomer | Surgery | 1250 E Marshall St, Richmond, VA 23298-5051 | 2007-03-16 |
| 1063546869 | Bradley M. Rodgers | Surgery | Uva Hospital W, Hospital Drive, Charlottesville, VA 22908-0001 | 2007-03-15 |
| 1992839716 | Eugene D. Mcgahren IIi | Surgery | 1204 W Main St, Charlottesville, VA 22903-2824 | 2007-03-15 |
| 1295829125 | Patricia A Lange | Surgery | 1250 E Marshall Street, Richmond, VA 23298-0510 | 2006-10-03 |
| 1245248947 | Children's Surgical Specialty Group, Inc | Surgery | 171 Kempsville Rd, Suite 201, Norfolk, VA 23502-4700 | 2006-08-04 |
| 1396752838 | Robert E. Kelly Jr. | Surgery | 601 Childrens Ln, Norfolk, VA 23507-1910 | 2006-08-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.