Provider Demographics
NPI:1922838507
Name:PRIVIA VIRTUAL HEALTH - CONNECTICUT PLLC
Entity type:Organization
Organization Name:PRIVIA VIRTUAL HEALTH - CONNECTICUT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GABBAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-569-9066
Mailing Address - Street 1:950 N GLEBE RD STE 700
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-4173
Mailing Address - Country:US
Mailing Address - Phone:484-569-9066
Mailing Address - Fax:
Practice Address - Street 1:116 WASHINGTON AVE STE 3
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-1721
Practice Address - Country:US
Practice Address - Phone:484-569-9066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-07
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty