Provider Demographics
NPI:1427592880
Name:CARTAGENA, CRISTINA MARIA (COA)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:MARIA
Last Name:CARTAGENA
Suffix:
Gender:F
Credentials:COA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9605 LITTLE COBBLER CT
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-4133
Mailing Address - Country:US
Mailing Address - Phone:571-447-1431
Mailing Address - Fax:
Practice Address - Street 1:6231 LEESBURG PIKE
Practice Address - Street 2:SUITE 608
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2102
Practice Address - Country:US
Practice Address - Phone:703-534-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-05
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA156FX1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1101XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic Assistant