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General NPI Number Information
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NPI Number | 1982276697
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Entity Type | Individual
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Provider Name | BRYAN C ALDEGHI CSFA
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Gender | Male
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Dates
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Enumeration Date | 07/13/2021
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Last Update Date | 04/13/2023
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Provider Practice Location Address
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Address Line | 44045 RIVERSIDE PKWY
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City | LEESBURG
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State | VA
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Zip | 20176-5101
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Country | US
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Telephone | 301-661-7117
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Fax |
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Provider Business Mailing Address
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Address Line | 11113 PUTMAN RD
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City | THURMONT
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State | MD
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Zip | 21788-2748
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Country | US
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Telephone | 301-661-7117
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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 | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | 0136000716
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 204207
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License Number State |
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