Healthcare Provider Details

I. General information

NPI: 1063823755
Provider Name (Legal Business Name): ALFRED PISANO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2014
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE BLDG 1, FLOOR 19, ROOM 19107
BETHESDA MD
20889-0004
US

IV. Provider business mailing address

8901 ROCKVILLE PIKE BLDG 19
BETHESDA MD
20889-0001
US

V. Phone/Fax

Practice location:
  • Phone: 301-319-8373
  • Fax: 301-295-9186
Mailing address:
  • Phone: 305-968-4378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number282390
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number282390
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: