Healthcare Provider Details

I. General information

NPI: 1548624323
Provider Name (Legal Business Name): ANNA MAGLIOLO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2016
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 ARLINGTON BLVD STE 210
FALLS CHURCH VA
22042-3000
US

IV. Provider business mailing address

10461 WHITE GRANITE DR STE 210
OAKTON VA
22124-2762
US

V. Phone/Fax

Practice location:
  • Phone: 703-359-5100
  • Fax:
Mailing address:
  • Phone: 703-359-5160
  • Fax: 703-383-9574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101277544
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: