Alexandria Lake Ridge Pediatrics

NPI #1316182116 in Lorton, Virginia

Provider Information

NPI Number: 1316182116
Entity Type: Organization
Organization Name: Alexandria Lake Ridge Pediatrics
Primary Specialty: Pediatrics
Enumeration Date: Dec 8, 2008
Last Updated: Dec 8, 2008

Practice Location

Address: 9010 LORTON STATION BLVD
Address 2: SUITE 100
City: Lorton
State: Virginia
ZIP Code: 22079
Phone: (703) 212-6600

Authorized Official

Name: DR. JON M FARBER, MD
Title: TREASURER
Phone: (703) 212-6600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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