1518162353 NPI number — DR. KATHERINE CIACCO PALATIANOS M.D., MPH

Table of content: DR. KATHERINE CIACCO PALATIANOS M.D., MPH (NPI 1518162353)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518162353 NPI number — DR. KATHERINE CIACCO PALATIANOS M.D., MPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PALATIANOS
Provider First Name:
KATHERINE
Provider Middle Name:
CIACCO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D., MPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CIACCO
Provider Other First Name:
KATHERINE
Provider Other Middle Name:
HELEN
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD, MPH
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1518162353
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
609 STILL CREEK LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GAITHERSBURG
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20878-2199
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-443-3223
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
WALTER REED ARMY MED CTR, OCC HEALTH CLINIC
Provider Second Line Business Practice Location Address:
6900 GEORGIA AVE NW
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20307-5001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-782-3611
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/20/2007

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: 2083P0500X , with the licence number:  D45151 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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