Healthcare Provider Details

I. General information

NPI: 1699115691
Provider Name (Legal Business Name): ABDUL HASEEB QAZI M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2013
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date: 04/03/2014
Reactivation Date: 05/14/2014

III. Provider practice location address

2901 TELESTAR CT STE 200
FALLS CHURCH VA
22042-1262
US

IV. Provider business mailing address

2901 TELESTAR CT STE 300
FALLS CHURCH VA
22042-1263
US

V. Phone/Fax

Practice location:
  • Phone: 703-573-3494
  • Fax: 703-573-5353
Mailing address:
  • Phone: 703-591-1688
  • Fax: 703-591-1445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number0101289984
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0101289984
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: