Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 0103300846 | VA |
NPI | 1255328423 |
---|---|
Provider Name | Dr. Jeffrey L Graziano |
First Address | Leesburg, VA 20176-2704 |
Second Address | Alexandria, VA 22304-1306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2005 |
Last Update Date | 05/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009304355 | (05) | VA |
77137 | (02) | VA |
U77137 | (02) | VA |