Healthcare Provider Details

I. General information

NPI: 1083741284
Provider Name (Legal Business Name): VINCENT J VAGHI MD AND JEANNE M BARBERA MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 10/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 WEST EDMUNSTON DRIVE SUITE 301
ROCKVILLE MD
20852-1246
US

IV. Provider business mailing address

50 WEST EDMUNSTON DRIVE SUITE 301
ROCKVILLE MD
20852-1246
US

V. Phone/Fax

Practice location:
  • Phone: 301-251-3704
  • Fax: 301-251-1783
Mailing address:
  • Phone: 301-251-3704
  • Fax: 301-251-1783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberD0031019
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberD0027925
License Number StateMD

VIII. Authorized Official

Name: VINCENT JAMES VAGHI
Title or Position: PRESIDENT
Credential: MD
Phone: 301-251-3704