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General NPI Number Information
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NPI Number | 1568886109
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Entity Type | Organization
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Legal Business Name | GONZALES-VIGILAR PSYCHIATRIC SERVICES
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Dates
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Enumeration Date | 02/18/2014
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Last Update Date | 09/02/2015
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Provider Practice Location Address
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Address Line | 44031 PIPELINE PLZ STE 205
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City | ASHBURN
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State | VA
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Zip | 20147-5888
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Country | US
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Telephone | 571-291-2449
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Fax | 571-291-3681
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Provider Business Mailing Address
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Address Line | 42455 BELMONT GLEN PL
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City | ASHBURN
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State | VA
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Zip | 20148-4320
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Country | US
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Telephone | 571-291-2449
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. GREGORIO G VIGILAR
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Credential | PH.D.
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Telephone | 571-291-2449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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