Provider Demographics
NPI:1548634306
Name:ANDRIKO, JOANN W (MD)
Entity type:Individual
Prefix:
First Name:JOANN
Middle Name:W
Last Name:ANDRIKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N STAFFORD ST
Mailing Address - Street 2:2425
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-1842
Mailing Address - Country:US
Mailing Address - Phone:301-213-1199
Mailing Address - Fax:
Practice Address - Street 1:14225 NEWBROOK DRIVE
Practice Address - Street 2:QUEST DIAGNOSTICS
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-0841
Practice Address - Country:US
Practice Address - Phone:703-802-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101238599207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology