Damon J Licari in Fairfax - Physician Assistant
Damon J Licari - NPI 1962495069
Damon J Licari is a Physician Assistant in Fairfax, Virginia. Damon J Licari practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Damon J Licari is 1962495069. The last update date is 2022-03-15.
Damon J Licari's current location address is 8081 Innovation Park Dr Ste 602, Fairfax, Virginia. You can contact this provider via phone number 5714723270 and fax number 5714723271. The mailing address for Damon J Licari is 8081 Innovation Park Dr Ste 602, Fairfax, Virginia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Damon J Licari |
|---|---|
| Address | 8081 Innovation Park Dr Ste 602, Fairfax, Virginia |
| Phone Number | 5714723270 |
| Fax Number | 5714723271 |
| Sole Proprietor | N |
| Credentials | PA |
NPI Number Detail
| NPI Number | 1962495069 |
|---|---|
| Provider Enumeration Date | 2005-08-24 |
| Last Updated Date | 2022-03-15 |
Provider Mailing Address Detail
| Address | 8081 Innovation Park Dr Ste 602 |
|---|---|
| City | Fairfax |
| State | Virginia (VA) |
| Post Code | 220314867 |
| Phone Number | 5714723270 |
| Fax Number | 5714723271 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 110001250 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| GP0624 | SC | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Damon J Licari?
The Damon J Licari has been issued the NPI (National Provider Identifier) 1962495069 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you provide the complete physical address where Damon J Licari is located?
The Damon J Licari is situated at the following address: 8081 Innovation Park Dr Ste 602, Fairfax, VA, 220314867.
What is the Damon J Licari's area of specialization and corresponding taxonomy classification?
The Damon J Licari's specialty field is Physician Assistant, and it falls under the taxonomy code 363A00000X, which categorizes healthcare providers based on their specialties.
On what date did Damon J Licari receive its 1962495069 assignment from the Centers for Medicare & Medicaid Services?
The Damon J Licari was assigned its 1962495069 on 2005-08-24, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the Damon J Licari's information last updated?
The Damon J Licari's information was last updated on 2022-03-15.