Healthcare Provider Details

I. General information

NPI: 1851494280
Provider Name (Legal Business Name): HAYK LEON KAFTARIAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 VARNUM ST NE SUITE 300
WASHINGTON DC
20017
US

IV. Provider business mailing address

1150 VARNUM ST NE SUITE 300
WASHINGTON DC
20017
US

V. Phone/Fax

Practice location:
  • Phone: 202-448-4091
  • Fax: 202-448-4093
Mailing address:
  • Phone: 202-448-4091
  • Fax: 202-448-4093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD5693
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: