Healthcare Provider Details

I. General information

NPI: 1508399320
Provider Name (Legal Business Name): ANGELINA SANGZI JUNE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2017
Last Update Date: 04/11/2023
Certification Date: 03/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 GALLOWS RD
FALLS CHURCH VA
22042-3307
US

IV. Provider business mailing address

8663 WELLFORD DR
ELLICOTT CITY MD
21042-6341
US

V. Phone/Fax

Practice location:
  • Phone: 703-289-1400
  • Fax:
Mailing address:
  • Phone: 443-878-8250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101269090
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number0101269090
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: