Healthcare Provider Details

I. General information

NPI: 1033181300
Provider Name (Legal Business Name): CHRISTINE MARIE VACCARO D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4416 E WEST HWY STE 410
BETHESDA MD
20814-4568
US

IV. Provider business mailing address

4416 E WEST HWY STE 410
BETHESDA MD
20814-4568
US

V. Phone/Fax

Practice location:
  • Phone: 202-888-6731
  • Fax: 202-851-5739
Mailing address:
  • Phone: 202-888-6731
  • Fax: 202-851-5739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number1042028
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number397
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: