Provider Demographics
NPI:1881829703
Name:GALARIA PLASTIC SURGERY AND DERMATOLOGY, PLC
Entity Type:Organization
Organization Name:GALARIA PLASTIC SURGERY AND DERMATOLOGY, PLC
Other - Org Name:GALARIA PLASTIC SURGERY AND HAND SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IRFAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GALARIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA
Authorized Official - Phone:571-449-0711
Mailing Address - Street 1:24805 PINEBROOK ROAD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20152
Mailing Address - Country:US
Mailing Address - Phone:703-327-3173
Mailing Address - Fax:703-327-1743
Practice Address - Street 1:24805 PINEBROOK ROAD
Practice Address - Street 2:SUITE #105
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20152
Practice Address - Country:US
Practice Address - Phone:703-327-3173
Practice Address - Fax:703-327-1743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-21
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101245107207N00000X
VA0101244923208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC10868Medicare PIN