Healthcare Provider Details

I. General information

NPI: 1902244684
Provider Name (Legal Business Name): OLIVIA JEN CARPINELLO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2013
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 L ST NW
WASHINGTON DC
20037-1527
US

IV. Provider business mailing address

8010 TOWERS CRESCENT DR FL 5
VIENNA VA
22182-2710
US

V. Phone/Fax

Practice location:
  • Phone: 571-789-2100
  • Fax: 571-789-2101
Mailing address:
  • Phone: 571-789-2100
  • Fax: 571-789-2101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberD83598
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberMD10002637
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number0101272434
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: