Healthcare Provider Details

I. General information

NPI: 1770228629
Provider Name (Legal Business Name): CHRISTIAN NOELLE LIUZZA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2022
Last Update Date: 05/04/2022
Certification Date: 05/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8414 OLD KEENE MILL RD UNIT A
SPRINGFIELD VA
22152-2302
US

IV. Provider business mailing address

8414 OLD KEENE MILL RD UNIT A
SPRINGFIELD VA
22152-2302
US

V. Phone/Fax

Practice location:
  • Phone: 703-913-6712
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202220102
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: