Healthcare Provider Details

I. General information

NPI: 1831586163
Provider Name (Legal Business Name): PARISA KAVIANY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2015
Last Update Date: 04/26/2021
Certification Date: 04/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW W3.5, 600
WASHINGTON DC
20010-2916
US

IV. Provider business mailing address

PO BOX 744785
ATLANTA GA
30374-4785
US

V. Phone/Fax

Practice location:
  • Phone: 202-476-3670
  • Fax: 202-476-4741
Mailing address:
  • Phone: 202-476-5000
  • Fax: 202-476-4741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License NumberPENDING
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: