Healthcare Provider Details

I. General information

NPI: 1184252330
Provider Name (Legal Business Name): ARLENE MARIE LORICA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 03/31/2020
Certification Date: 03/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7902 TYSONS ONE PL UNIT 2613
MC LEAN VA
22102-5239
US

IV. Provider business mailing address

8601 CHATEAU DR
POTOMAC MD
20854-4528
US

V. Phone/Fax

Practice location:
  • Phone: 301-767-0375
  • Fax:
Mailing address:
  • Phone: 301-767-0375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101056560
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: