Provider Demographics
NPI:1356469407
Name:HARRISONBURG DERMATOLOGY PLC
Entity Type:Organization
Organization Name:HARRISONBURG DERMATOLOGY PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JERRI
Authorized Official - Middle Name:ALLEY
Authorized Official - Last Name:ALEXIOU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-433-8700
Mailing Address - Street 1:2062 PRO POINTE LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-8021
Mailing Address - Country:US
Mailing Address - Phone:540-433-8700
Mailing Address - Fax:540-433-8080
Practice Address - Street 1:2062 PRO POINTE LN
Practice Address - Street 2:SUITE 100
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-8021
Practice Address - Country:US
Practice Address - Phone:540-433-8700
Practice Address - Fax:540-433-8080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101230036207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty