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NPI Code Detail

MEDICARE: DR. HERAN KALYIE

MEDICARE: DR. HERAN KALYIE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist0202214518VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NAOTHERNA

General Provider Information

NPI Number : 1740877737
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HERAN KALYIE
Provider Business Mailing Address
First Line : 6404 WILLIAMSBURG BLVD
Second Line :
City : ARLINGTON
State : VA
Zip : 22207-1153
Country : US
Telephone Number : 571-723-6722
Fax Number :
Provider Business Practice Location Address
First Line : 6404 WILLIAMSBURG BLVD
Second Line :
City : ARLINGTON
State : VA
Zip : 22207-1153
Country : US
Telephone Number : 571-723-6722
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/24/2020
Last Update Date : 12/24/2020

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