Provider Demographics
NPI:1053935932
Name:FAMIGLIETTI, GINA MARIE (MPAS, PA-C)
Entity type:Individual
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First Name:GINA
Middle Name:MARIE
Last Name:FAMIGLIETTI
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Gender:F
Credentials:MPAS, PA-C
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Mailing Address - Street 1:2415 MUSGROVE RD
Mailing Address - Street 2:STE 105
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-5224
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2415 MUSGROVE ROAD
Practice Address - Street 2:SUITE 105
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904
Practice Address - Country:US
Practice Address - Phone:301-989-0193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-05
Last Update Date:2020-10-07
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant