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General NPI Number Information
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NPI Number | 1912154188
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Entity Type | Organization
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Legal Business Name | MARCELO ANDREOLI MD
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Dates
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Enumeration Date | 08/19/2008
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Last Update Date | 08/19/2008
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Provider Practice Location Address
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Address Line | 2946 SLEEPY HOLLOW RD STE 2D
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City | FALLS CHURCH
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State | VA
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Zip | 22044-2003
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Country | US
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Telephone | 703-531-1054
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Fax | 703-531-1090
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Provider Business Mailing Address
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Address Line | 2946 SLEEPY HOLLOW RD STE 2D
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City | FALLS CHURCH
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State | VA
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Zip | 22044-2003
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Country | US
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Telephone | 703-531-1054
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Fax | 703-531-1090
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Authorized Official
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Title or Position | MANAGER
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Name | MS. LIA FORSYTHE
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Credential |
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Telephone | 703-531-1054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0101055708
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License Number State | VA
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