1710995329 NPI number — DR. ALFRED J GALIANI OD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710995329 NPI number — DR. ALFRED J GALIANI OD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GALIANI
Provider First Name:
ALFRED
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
OD
Provider Gender Code:
M

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:
1710995329
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:
7263E ARLINGTON BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FALLS CHURCH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22042-3219
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-573-1200
Provider Business Mailing Address Fax Number:
703-573-1250

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1800 S BELL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22202-3558
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-413-1400
Provider Business Practice Location Address Fax Number:
703-413-1403
Provider Enumeration Date:
08/03/2006

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: 152W00000X , with the licence number:  0618000291 , 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: 4461406 . This is a "AETNA-PPO" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 2119610 . This is a "AETNA-HMO" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 9314-005 . This is a "BCBS / CAREFIRST" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 105008 . This is a "BCBS/ANTHEM - ARLINGTON" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 311874 . This is a "ALLIANCE/MDIPA/MAMSI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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