Provider Demographics
NPI:1689423915
Name:VIRGINIA ALLERGY PLLC
Entity type:Organization
Organization Name:VIRGINIA ALLERGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GUILLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-932-7335
Mailing Address - Street 1:10134 COLVIN RUN RD STE D
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:22066-1841
Mailing Address - Country:US
Mailing Address - Phone:703-757-7950
Mailing Address - Fax:703-757-7953
Practice Address - Street 1:10134 COLVIN RUN RD STE D
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:VA
Practice Address - Zip Code:22066-1841
Practice Address - Country:US
Practice Address - Phone:703-757-7950
Practice Address - Fax:703-757-7953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty