| Organization Name: | NEUROPSYCHOLOGY AT BURKE, LLC |
| NPI Number: | 1750698239 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PAUL FEDIO (PRESIDENT) |
| Mailing Address: | 9408 Raintree Rd Burke |
| State: | VA US |
| Postal Code: | 220151946 |
| Phone Number: | 7034267246 |
| Fax Number: | 7034264223 |
| NPI Enumeration Date: | 09/07/2010 |
| NPI Last Update Date: | 09/08/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103G00000X |
| License Number: | 0810002714 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Clinical Neuropsychologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |