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General NPI Number Information
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NPI Number | 1952812174
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Entity Type | Individual
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Provider Name | VITTORIA DUSSIAS PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/15/2017
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Last Update Date | 03/24/2020
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Provider Practice Location Address
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Address Line | 3800 RESERVOIR RD NW
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City | WASHINGTON
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State | DC
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Zip | 20007-2113
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Country | US
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Telephone | 240-444-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 8011 NEW HAMPSHIRE AVE
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City | HYATTSVILLE
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State | MD
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Zip | 20783-4612
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Country | US
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Telephone | 240-670-7156
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C0006646
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA031645
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License Number State | DC
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