1023036308 NPI number — DR. JOHN L ALBRIGO MD

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 1023036308 NPI number — DR. JOHN L ALBRIGO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALBRIGO
Provider First Name:
JOHN
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1023036308
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/10/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6302 WATERWAY DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22206
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-892-6500
Provider Business Mailing Address Fax Number:
703-799-5989

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2445 ARMY NAVY DR
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:
22206-2905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-892-6500
Provider Business Practice Location Address Fax Number:
703-892-1550
Provider Enumeration Date:
07/17/2006

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: 174400000X , with the licence number:  0101027640 , 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: 4050679 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0283528 . This is a "CIGNA ID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 148820100 . This is a "DEPT OF LABOR ID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 212637 . This is a "MAMSI ID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 25090003 . This is a "BLUE CROSS BLUE SHIELD ID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00097 . This is a "UNITED ID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 033557 . This is a "ANTHEM ID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0535640 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 502338 . This is a "NCPPO" identifier . This identifiers is of the category "OTHER".




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