Fairfax Family Practice

NPI #1326436304 in Herndon, Virginia

Provider Information

NPI Number: 1326436304
Entity Type: Organization
Organization Name: Fairfax Family Practice
Primary Specialty: Family Medicine
Enumeration Date: Dec 29, 2014
Last Updated: Nov 9, 2016

Practice Location

Address: 334 ELDEN ST
City: Herndon
State: Virginia
ZIP Code: 20170-4818
Phone: (571) 665-4000

Authorized Official

Name: AHMAD NUSRAT
Title: PRESIDENT
Phone: (703) 507-7505

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Primary Care — Primary Care	261QP2300X
Clinic/Center	261Q00000X
Clinic/Center - Health Service — Health Service	261QH0100X
Clinic/Center - Urgent Care — Urgent Care	261QU0200X
Family Medicine	207Q00000X	Primary

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