Healthcare Provider Details

I. General information

NPI: 1528163623
Provider Name (Legal Business Name): CYNTHIA JAYNE MAGHAKIAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 02/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 BREMO RD SUITE 202
RICHMOND VA
23226-2400
US

IV. Provider business mailing address

2004 BREMO RD STE 201
RICHMOND VA
23226-2442
US

V. Phone/Fax

Practice location:
  • Phone: 804-272-2000
  • Fax: 804-272-2030
Mailing address:
  • Phone: 804-272-2000
  • Fax: 804-272-2030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101047868
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: