Healthcare Provider Details

I. General information

NPI: 1689020174
Provider Name (Legal Business Name): NEDA AMINI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2016
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 HARRY S TRUMAN DR N
LARGO MD
20774-5477
US

IV. Provider business mailing address

29 S GREENE ST STE GS104A
BALTIMORE MD
21201-1504
US

V. Phone/Fax

Practice location:
  • Phone: 667-214-1718
  • Fax: 410-328-5147
Mailing address:
  • Phone: 667-214-1734
  • Fax: 410-706-6976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberP32551
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: