Healthcare Provider Details

I. General information

NPI: 1831337898
Provider Name (Legal Business Name): NADERI CENTER FOR COSMETIC SURGERY & SKIN CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2009
Last Update Date: 02/28/2022
Certification Date: 02/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 TOWN CENTER PARKWAY SUITE 551
RESTON VA
20190-3300
US

IV. Provider business mailing address

1850 TOWN CENTER PARKWAY SUITE 551
RESTON VA
20190-3300
US

V. Phone/Fax

Practice location:
  • Phone: 703-481-0002
  • Fax: 703-481-5002
Mailing address:
  • Phone: 703-481-0002
  • Fax: 703-481-5002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SHERVIN NADERI
Title or Position: OWNER
Credential: MD
Phone: 703-481-0002