Provider Demographics
NPI:1295735587
Name:MECCARIELLO, ANNE
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:
Last Name:MECCARIELLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9314 OLD KEENE MILL RD
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-4284
Mailing Address - Country:US
Mailing Address - Phone:703-569-3131
Mailing Address - Fax:703-451-9291
Practice Address - Street 1:9314 OLD KEENE MILL RD
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-4284
Practice Address - Country:US
Practice Address - Phone:703-569-3131
Practice Address - Fax:703-451-9291
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000325152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009236945Medicaid
VA0760070001Medicare NSC
VAU29762Medicare UPIN
VA009236945Medicaid