Provider Information for 1427061381
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Dr. REENA RAO BOMMASANI M.D.
Sex: Female
NPI: 1427061381
Last Updated: 2023-08-10
Certification Date: 2023-08-10
Certification Date: 2023-08-10
Details
| Name | Value | ||||||||||||||||
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| NPI | 1427061381 | ||||||||||||||||
| Enumeration Date | 2006-08-14 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 13168 CENTERPOINTE WAY STE 101 WOODBRIDGE, VA 22193-5287 United States Phone: 703-730-2000 | Fax:703-730-6767 | ||||||||||||||||
| Primary Practice Address | 13168 CENTERPOINTE WAY STE 101 WOODBRIDGE, VA 22193-5287 United States Phone: 703-730-2000 | Fax:703-730-6767 | ||||||||||||||||
| Secondary Practice Address(es) | 6356 HOADLY RD 1043 STERLING RD STE 104 11213 LEE HWY STE H 24430 STONE SPRINGS BLVD STE 230 | ||||||||||||||||
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