Healthcare Provider Details

I. General information

NPI: 1851136683
Provider Name (Legal Business Name): CONSULTANT CORNER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2024
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11166 FAIRFAX BLVD STE 500
FAIRFAX VA
22030-5017
US

IV. Provider business mailing address

11166 FAIRFAX BLVD STE 500
FAIRFAX VA
22030-5017
US

V. Phone/Fax

Practice location:
  • Phone: 347-401-8280
  • Fax: 928-318-6622
Mailing address:
  • Phone: 347-401-8280
  • Fax: 928-318-6622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SAQIB A CHAUDHRY
Title or Position: OWNER / CEO
Credential: MD
Phone: 347-401-8280