Provider Demographics
NPI:1659613222
Name:PIZZA, CELESTE P (MD)
Entity type:Individual
Prefix:
First Name:CELESTE
Middle Name:P
Last Name:PIZZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9301 PRETORIA PL APT 26
Mailing Address - Street 2:
Mailing Address - City:DULLES
Mailing Address - State:VA
Mailing Address - Zip Code:20189-9301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2401 E STREET NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20520-5716
Practice Address - Country:US
Practice Address - Phone:202-663-1649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA266974207R00000X
VA0101271561207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD0092449OtherMD MEDICAL LICENSE
VA0101271561OtherVA MEDICAL LICENSE
VA0101271561OtherVA MEDICAL LICENSE
VA0101271561OtherVA MEDICAL LICENSE