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General NPI Number Information
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NPI Number | 1003312729
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Entity Type | Individual
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Provider Name | BENJAMIN BEHNOUD NIA MD
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Gender | Male
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Dates
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Enumeration Date | 04/02/2018
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Last Update Date | 08/03/2022
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Provider Practice Location Address
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Address Line | 3700 JOSEPH SIEWICK DR STE 302
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City | FAIRFAX
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State | VA
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Zip | 22033-1739
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Country | US
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Telephone | 703-648-2488
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Fax | 703-648-2489
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Provider Business Mailing Address
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Address Line | 1221 MASSACHUSETTS AVE NW APT 1017
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City | WASHINGTON
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State | DC
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Zip | 20005-5331
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Country | US
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Telephone | 328-636-3958
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 0101275514
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | BP10063399
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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