Provider Demographics
NPI:1336688357
Name:ALOT, GERALDINE
Entity Type:Individual
Prefix:
First Name:GERALDINE
Middle Name:
Last Name:ALOT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15763 POINTER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1710
Mailing Address - Country:US
Mailing Address - Phone:240-898-7485
Mailing Address - Fax:
Practice Address - Street 1:15763 POINTER RIDGE DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-1710
Practice Address - Country:US
Practice Address - Phone:240-898-7485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-23
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12625390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program