Healthcare Provider Details

I. General information

NPI: 1932359288
Provider Name (Legal Business Name): DR. AURELIO JOSEPH OGILVIE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2008
Last Update Date: 08/29/2023
Certification Date: 01/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 E CAPITOL ST NE
WASHINGTON DC
20003-3906
US

IV. Provider business mailing address

1002 E CAPITOL ST NE BSMT SUITE
WASHINGTON DC
20003-3906
US

V. Phone/Fax

Practice location:
  • Phone: 202-552-1741
  • Fax:
Mailing address:
  • Phone: 202-552-1741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810004820
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: