1134118417 NPI number — DR. MARGARET THERESA CARLINI MD

Table of content: ANNA JACKSON BCBA (NPI 1134483613)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134118417 NPI number — DR. MARGARET THERESA CARLINI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARLINI
Provider First Name:
MARGARET
Provider Middle Name:
THERESA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LAMMOND
Provider Other First Name:
MARGARET
Provider Other Middle Name:
THERESA
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1134118417
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/21/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8926 WOODYARD RD
Provider Second Line Business Mailing Address:
SUITE 701
Provider Business Mailing Address City Name:
CLINTON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20735-4220
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-856-1682
Provider Business Mailing Address Fax Number:
301-856-8214

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9455 LORTON MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LORTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22079-1963
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-856-1682
Provider Business Practice Location Address Fax Number:
703-339-6351
Provider Enumeration Date:
10/19/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2081P2900X , with the licence number:  0101045524 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 176608 . This is a "METRO MEDICARE GROUP PROVIDER #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 46950037 . This is a "CAREFIRST NCA" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00887811 . This is a "RAILROAD MEDICARE PTAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 641121YZW . This is a "MEDICARE PTAN" identifier . This identifiers is of the category "OTHER".




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