Healthcare Provider Details

I. General information

NPI: 1295824779
Provider Name (Legal Business Name): CLAIRE M CIFALOGLIO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3033 WILSON BLVD SUITE 600B
ARLINGTON VA
22201-3843
US

IV. Provider business mailing address

3916 MILITARY RD
ARLINGTON VA
22207-4858
US

V. Phone/Fax

Practice location:
  • Phone: 703-228-1656
  • Fax: 703-228-1133
Mailing address:
  • Phone: 703-351-6168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101047496
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: