Healthcare Provider Details

I. General information

NPI: 1649694993
Provider Name (Legal Business Name): CAROL CIOFALO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2014
Last Update Date: 02/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5209 11TH RD N
ARLINGTON VA
22205-2424
US

IV. Provider business mailing address

5209 11TH RD N
ARLINGTON VA
22205-2424
US

V. Phone/Fax

Practice location:
  • Phone: 703-243-5233
  • Fax:
Mailing address:
  • Phone: 703-243-5233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number0101033910
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: