Basic Information
| Provider Information | |||||||||
| NPI: | 1043403397 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ANEZ & BITAR MEDICAL PC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | TYSONS CORNER PEDIATRICS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8365A GREENSBORO DR | ||||||||
| Address2: | |||||||||
| City: | MC LEAN | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221023530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7033564444 | ||||||||
| FaxNumber: | 7037340129 | ||||||||
| Practice Location | |||||||||
| Address1: | 8365A GREENSBORO DR | ||||||||
| Address2: | |||||||||
| City: | MC LEAN | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221023530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7033564444 | ||||||||
| FaxNumber: | 7037340129 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2007 | ||||||||
| LastUpdateDate: | 10/18/2012 | ||||||||
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| AuthorizedOfficialLastName: | ANEZ | ||||||||
| AuthorizedOfficialFirstName: | YASMIN | ||||||||
| AuthorizedOfficialMiddleName: | K. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7033564444 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 0101035273 | VA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.