Healthcare Provider Details

I. General information

NPI: 1689840803
Provider Name (Legal Business Name): MARISSA LYNN ALBANO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2008
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8136 OLD KEENE MILL RD STE 300
SPRINGFIELD VA
22152-1850
US

IV. Provider business mailing address

8136 OLD KEENE MILL RD STE B300
SPRINGFIELD VA
22152-1856
US

V. Phone/Fax

Practice location:
  • Phone: 703-451-6111
  • Fax:
Mailing address:
  • Phone: 703-451-6111
  • Fax: 703-451-6247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number101249495
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License Number0101249495
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: