Provider Demographics
NPI:1922364116
Name:PAOLINI, LARITTA
Entity Type:Individual
Prefix:DR
First Name:LARITTA
Middle Name:
Last Name:PAOLINI
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:LARITTA
Other - Middle Name:
Other - Last Name:AMANBEKOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:606 JOHN MARSHALL DR NE
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-3522
Mailing Address - Country:US
Mailing Address - Phone:703-509-0936
Mailing Address - Fax:
Practice Address - Street 1:131 PARK ST NE STE 7C
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4641
Practice Address - Country:US
Practice Address - Phone:703-509-0936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121-000661171100000X
MDU01930171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist