Healthcare Provider Details

I. General information

NPI: 1285525378
Provider Name (Legal Business Name): SAYED AHMAD SHAH SEKANDARY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2025
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7509 LISA LANE
HENRICO VA
23294
US

IV. Provider business mailing address

7509 LISA LN
HENRICO VA
23294-4607
US

V. Phone/Fax

Practice location:
  • Phone: 804-910-8745
  • Fax:
Mailing address:
  • Phone: 804-910-8745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: