Provider Demographics
NPI:1629066816
Name:RANIERI, GERARD JULIO (DPM)
Entity Type:Individual
Prefix:DR
First Name:GERARD
Middle Name:JULIO
Last Name:RANIERI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12656 LAKE RIDGE DR STE B
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-7504
Mailing Address - Country:US
Mailing Address - Phone:703-491-2603
Mailing Address - Fax:703-491-0752
Practice Address - Street 1:12656-B LAKE RIDGE DRIVE
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-7504
Practice Address - Country:US
Practice Address - Phone:703-491-2603
Practice Address - Fax:703-491-0752
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103000771213E00000X
OH36002143213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA299434OtherANTHEM
311280402OtherTRICARE TRICARE PRIME
311280402OtherUNICARE NCPPO
4204OtherCARE FIRST BCBS
VA417278OtherONE NET
0004509259OtherAETNA PPO
VA299447OtherANTHEM
311280402OtherNCPPO
0576286OtherAETNA HMO
226088OtherHEALTHKEEPERS ANTHEM
1858423OtherCIGNA PPO
311280402OtherMAILHANDLERS PPO
33004OtherCOMMUNITY CARE NTWK
4204OtherCARE FIRST BCBS
311280402OtherTRICARE TRICARE PRIME
VA299447OtherANTHEM
VA417278OtherONE NET
311280402OtherUNICARE NCPPO
VA0647020001Medicare NSC
VA480017779Medicare PIN