Provider Demographics
NPI:1861517963
Name:HEMORRHOID RELIEF CENTER OF VIRGINIA, INC.
Entity type:Organization
Organization Name:HEMORRHOID RELIEF CENTER OF VIRGINIA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:ABRAMOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-556-6620
Mailing Address - Street 1:1950 OLD GALLOWS RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3990
Mailing Address - Country:US
Mailing Address - Phone:703-556-6620
Mailing Address - Fax:703-556-6625
Practice Address - Street 1:3020 HAMAKER CT
Practice Address - Street 2:SUITE B110
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2238
Practice Address - Country:US
Practice Address - Phone:703-849-9500
Practice Address - Fax:703-849-1469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101237614207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG01155Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER