Provider Demographics
NPI:1023036308
Name:ALBRIGO, JOHN L (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:L
Last Name:ALBRIGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6302 WATERWAY DRIVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206
Mailing Address - Country:US
Mailing Address - Phone:703-892-6500
Mailing Address - Fax:703-799-5989
Practice Address - Street 1:2445 ARMY NAVY DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-2905
Practice Address - Country:US
Practice Address - Phone:703-892-6500
Practice Address - Fax:703-892-1550
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101027640174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
4050679OtherAETNA PPO
0283528OtherCIGNA ID
148820100OtherDEPT OF LABOR ID
212637OtherMAMSI ID
25090003OtherBLUE CROSS BLUE SHIELD ID
00097OtherUNITED ID
033557OtherANTHEM ID
0535640OtherAETNA HMO
502338OtherNCPPO
0283528OtherCIGNA ID
VA116224A47Medicare PIN
200024906Medicare PIN