Organization · Type 2 NPI

Premise Heath of Connecticut Medical PC

Primary Care Clinic/Center · Reston, VA

NPI number 1760625917 Active

Practice location

12000 Sunrise Valley Dr Bldg E
Reston, VA 20191-3403

Fax (615) 468-0477

Specialties and licenses

TaxonomyCodeLicense
Primary Care Clinic/Center Primary 261QP2300XNone listed

Primary Care Clinic/Center: Definition to come...

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About NPI 1760625917

Premise Heath of Connecticut Medical PC's National Provider Identifier is 1760625917, issued on Apr 16, 2009. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Reston, VA. The record was last updated on Mar 13, 2026.