Provider Demographics
NPI:1063924264
Name:CARRIE PAGLIANO PT
Entity type:Organization
Organization Name:CARRIE PAGLIANO PT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGLIANO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:571-336-6950
Mailing Address - Street 1:2200 N GEORGE MASON DR UNIT 7582
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-8020
Mailing Address - Country:US
Mailing Address - Phone:571-336-6950
Mailing Address - Fax:
Practice Address - Street 1:2200 N GEORGE MASON DR UNIT 7582
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22207-8020
Practice Address - Country:US
Practice Address - Phone:571-336-6950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-27
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2000X
VA2305203442225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty