Provider Demographics
NPI:1518162312
Name:JOSEPH J PALOMBI MD PC
Entity Type:Organization
Organization Name:JOSEPH J PALOMBI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:PALOMBI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-368-1715
Mailing Address - Street 1:1299 WOODSIDE DR
Mailing Address - Street 2:
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-1528
Mailing Address - Country:US
Mailing Address - Phone:703-368-1715
Mailing Address - Fax:
Practice Address - Street 1:8424 DORSEY CIR
Practice Address - Street 2:SUITE 102
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-8301
Practice Address - Country:US
Practice Address - Phone:703-368-1715
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010336962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1346241619OtherINDIVIDUAL NPI
VA95861OtherAMERIGROUP
VAB6700001OtherCARE FIRST
VA211072OtherANTHEM
VA7106653Medicaid
VA1346241619OtherINDIVIDUAL NPI
DC419216Medicare ID - Type Unspecified