Healthcare Provider Details

I. General information

NPI: 1063924264
Provider Name (Legal Business Name): CARRIE PAGLIANO PT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2017
Last Update Date: 10/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 N GEORGE MASON DR UNIT 7582
ARLINGTON VA
22207-8020
US

IV. Provider business mailing address

2200 N GEORGE MASON DR UNIT 7582
ARLINGTON VA
22207-8020
US

V. Phone/Fax

Practice location:
  • Phone: 571-336-6950
  • Fax:
Mailing address:
  • Phone: 571-336-6950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305203442
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CARRIE PAGLIANO
Title or Position: PT/OWNER
Credential: PT
Phone: 571-336-6950