Provider Demographics
NPI:1225202435
Name:ANDRES C. OLACIREGUI, M.D., INC.
Entity Type:Organization
Organization Name:ANDRES C. OLACIREGUI, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:C
Authorized Official - Last Name:OLACIREGUI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-518-1104
Mailing Address - Street 1:11207A LOCKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-4550
Mailing Address - Country:US
Mailing Address - Phone:301-518-1104
Mailing Address - Fax:301-622-3050
Practice Address - Street 1:11207A LOCKWOOD DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-4550
Practice Address - Country:US
Practice Address - Phone:301-518-1104
Practice Address - Fax:301-622-3050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0009180101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty