| Doctor Name: | RICHARD S. PERGOLIZZI |
| NPI Number: | 1053345256 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 0101231383 |
| Business Practice Address: | 2722 Merrilee Dr #230 Fairfax, VA - 220314400 |
| Business Phone Number: | 7036980056 |
| Business Fax Number: | 7035730880 |
| Mailing Address: | Po Box 3650, FAIRFAX |
| State: | VA |
| Postal Code: | 220383650 |
| Phone Number: | 7036980056 |
| Fax Number: | 7065730880 |
| NPI Enumeration Date: | 07/11/2006 |
| NPI Last Update Date: | 01/08/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | 0101231383 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |