Provider Demographics
NPI:1417082231
Name:MARK A BARTOLOZZI MD & JOSEPH J.MAGALSKI, JR. M.D.P.C
Entity Type:Organization
Organization Name:MARK A BARTOLOZZI MD & JOSEPH J.MAGALSKI, JR. M.D.P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SANBORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-730-4848
Mailing Address - Street 1:9001 DIGGES RD STE 204
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4414
Mailing Address - Country:US
Mailing Address - Phone:703-257-9234
Mailing Address - Fax:703-257-1560
Practice Address - Street 1:2280 OPITZ BLVD STE 310
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3362
Practice Address - Country:US
Practice Address - Phone:703-730-4848
Practice Address - Fax:703-730-7236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101048180208600000X
VA0101221455208600000X
VA0101236256208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7306105Medicaid
VA7306105Medicaid
VAC06144Medicare PIN