Healthcare Provider Details

I. General information

NPI: 1821800723
Provider Name (Legal Business Name): PRIVIA MEDICAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1160 VARNUM ST NE STE 100
WASHINGTON DC
20017-2106
US

IV. Provider business mailing address

950 N GLEBE RD STE 700
ARLINGTON VA
22203-4173
US

V. Phone/Fax

Practice location:
  • Phone: 202-832-1800
  • Fax:
Mailing address:
  • Phone: 800-973-1442
  • Fax: 571-982-6636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MARIA GABBAI
Title or Position: DIRECTOR
Credential:
Phone: 484-301-0314