Healthcare Provider Details

I. General information

NPI: 1114613726
Provider Name (Legal Business Name): CIARA ALBRITTAIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2023
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11637 TERRACE DR STE 100
WALDORF MD
20602-3707
US

IV. Provider business mailing address

11637 TERRACE DR STE 100
WALDORF MD
20602-3707
US

V. Phone/Fax

Practice location:
  • Phone: 301-870-7287
  • Fax: 301-870-0687
Mailing address:
  • Phone: 301-870-7287
  • Fax: 301-870-0687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberC0009561
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: