Provider Demographics
NPI:1366516387
Name:GOLD, LIZA HANNAH (MD)
Entity type:Individual
Prefix:DR
First Name:LIZA
Middle Name:HANNAH
Last Name:GOLD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2501 N GLEBE RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-3558
Mailing Address - Country:US
Mailing Address - Phone:703-875-0435
Mailing Address - Fax:703-875-0434
Practice Address - Street 1:2120 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-5718
Practice Address - Country:US
Practice Address - Phone:703-228-1600
Practice Address - Fax:703-228-1117
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA475902084F0202X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
E16216Medicare UPIN