MEDICARE: VALERIE CARREGAL AUGELLO D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207KI0005X	Clinical & Laboratory Immunology (Allergy & Immunology) Physician	MD31422	DC

General Provider Information

NPI Number	:	1477576791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE CARREGAL AUGELLO D.O.

Provider Business Mailing Address
First Line	:	2100 PENNSYLVANIA AVE NW STE A
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20037-3202
Country	:	US
Telephone Number	:	202-861-8888
Fax Number	:	202-861-8887

Provider Business Practice Location Address
First Line	:	2100 PENNSYLVANIA AVE NW STE A
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20037-3202
Country	:	US
Telephone Number	:	202-861-8888
Fax Number	:	202-861-8887

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	07/08/2007

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