Healthcare Provider Details

I. General information

NPI: 1801139506
Provider Name (Legal Business Name): ARASH ZIRAKZADEH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2013
Last Update Date: 04/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8348 TRAFORD LN STE 100
SPRINGFIELD VA
22152-1650
US

IV. Provider business mailing address

1952 KENNEDY DR APT 204
MC LEAN VA
22102-4755
US

V. Phone/Fax

Practice location:
  • Phone: 703-569-1097
  • Fax:
Mailing address:
  • Phone: 571-344-9926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305207852
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: