Healthcare Provider Details

I. General information

NPI: 1093453326
Provider Name (Legal Business Name): VIRGINIA PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2022
Last Update Date: 05/25/2022
Certification Date: 05/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 WESTERRE PKWY STE 300
RICHMOND VA
23233-1339
US

IV. Provider business mailing address

1212 ASTLEY CT
MIDLOTHIAN VA
23114-4505
US

V. Phone/Fax

Practice location:
  • Phone: 804-336-2885
  • Fax: 804-315-2341
Mailing address:
  • Phone: 347-622-3313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SHERIN MOIDEEN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 804-336-2885