Healthcare Provider Details

I. General information

NPI: 1518162312
Provider Name (Legal Business Name): JOSEPH J PALOMBI MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8424 DORSEY CIR SUITE 102
MANASSAS VA
20110-8301
US

IV. Provider business mailing address

1299 WOODSIDE DR
MCLEAN VA
22102-1528
US

V. Phone/Fax

Practice location:
  • Phone: 703-368-1715
  • Fax:
Mailing address:
  • Phone: 703-368-1715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101033696
License Number StateVA

VIII. Authorized Official

Name: DR. JOSEPH J PALOMBI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 703-368-1715