Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Modern Vascular of Fairfax, LLC

Organization Vascular & Interventional Radiology Physician · NPI 1821553108

Modern Vascular of Fairfax, LLC is a Vascular & Interventional Radiology Physician in Fairfax, Virginia. Registered with an NPI since 2019.

In the registry since
2019
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2812 Old Lee Hwy Ste 100B
Fairfax, VA 22031-4315
Phone: (571) 279-6849
Fax: (571) 281-8697
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Vascular & Interventional Radiology Physician (primary) Taxonomy 2085R0204X
Vascular-Interventional Technology Radiologic Technologist Taxonomy 2471V0106X

Record details

NPI number1821553108
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Yury Gampel — Manager · (818) 880-8605
NPI enumeratedJanuary 31, 2019
Last updated in NPPESJanuary 31, 2019
Mailing address26500 Agoura Rd Ste 102-587, Calabasas, CA 91302-1952

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