Elden St. Pediatrics

NPI #1215091038 in Herndon, Virginia

Provider Information

NPI Number: 1215091038
Entity Type: Organization
Organization Name: Elden St. Pediatrics
Primary Specialty: Pediatrics
Enumeration Date: Dec 20, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 110 ELDEN ST
Address 2: SUITE #D
City: Herndon
State: Virginia
ZIP Code: 20170-4891
Phone: (703) 471-6996

Authorized Official

Name: MRS. MILLICENT M TETTEYFIO, RN
Title: RN.OFC.MGR
Phone: (703) 471-6996

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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