Healthcare Provider Details

I. General information

NPI: 1518141571
Provider Name (Legal Business Name): GERARD J. RANIERI DPM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2007
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8637 ENGLESIDE OFFICE PARK
ALEXANDRIA VA
22309-4132
US

IV. Provider business mailing address

12656 LAKE RIDGE DR STE B
WOODBRIDGE VA
22192-7504
US

V. Phone/Fax

Practice location:
  • Phone: 703-780-8100
  • Fax: 703-780-7442
Mailing address:
  • Phone: 703-491-2603
  • Fax: 703-491-0752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0103000771
License Number StateVA

VIII. Authorized Official

Name: DR. GERARD J RANIERI
Title or Position: SOLE PROPRIETOR
Credential: DPM
Phone: 703-491-2603