1235109547 NPI number — DR. MARGARET MACKRELL GAGLIONE M.D.

Table of content: DR. MARGARET MACKRELL GAGLIONE M.D. (NPI 1235109547)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235109547 NPI number — DR. MARGARET MACKRELL GAGLIONE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GAGLIONE
Provider First Name:
MARGARET
Provider Middle Name:
MACKRELL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235109547
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/25/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
860 OMNI BLVD
Provider Second Line Business Mailing Address:
SUITE 303
Provider Business Mailing Address City Name:
NEWPORT NEWS
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23606-4430
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-232-8769
Provider Business Mailing Address Fax Number:
757-232-8875

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1405 KEMPSVILLE ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHESAPEAKE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23320-2111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-644-6819
Provider Business Practice Location Address Fax Number:
757-644-6816
Provider Enumeration Date:
01/26/2006

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: 207R00000X , with the licence number:  0101050879 , 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)





Copyright © 2007-2024 www.npivalidator.com