Cusicanqui Monrroy, Miriam Jacqueline Nicolasa

Cusicanqui Monrroy, Miriam Jacqueline Nicolasa is an sole proprietor health care provider with primary practice located at 1715 N George Mason Dr Suite 501, Arlington VA 22205-3609. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Cusicanqui Monrroy, Miriam Jacqueline Nicolasa can be contacted via phone (703) 527-4466.

Contact Information

Primary practice address
1715 N George Mason Dr Suite 501 Arlington VA 22205-3609
Fax: (703) 552-1326
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0101241806 Virginia

Profile Details

NPI number 1497945174
LBN Legal business name Cusicanqui Monrroy, Miriam Jacqueline Nicolasa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 28th, 2007
Last updated Aug 10th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497945174 NPPES
Virginia Other 132601 MEDICARE PTAN
Virginia MEDICAID 7100033620 MEDICARE PTAN
Virginia MEDICAID 1497945174 MEDICARE PTAN

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