Healthcare Provider Details

I. General information

NPI: 1497696470
Provider Name (Legal Business Name): MUNEEZA SYED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12445 HEDGES RUN DR
LAKE RIDGE VA
22192-1715
US

IV. Provider business mailing address

12445 HEDGES RUN DR
LAKE RIDGE VA
22192-1715
US

V. Phone/Fax

Practice location:
  • Phone: 703-491-7694
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number0202223357
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202223357
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: