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General NPI Number Information
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NPI Number | 1033874243
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Entity Type | Individual
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Provider Name | ROSHANAK NOROUZI
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Gender | Female
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Dates
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Enumeration Date | 11/02/2021
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Last Update Date | 11/16/2021
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Provider Practice Location Address
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Address Line | 9582 OLD KEENE MILL RD
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City | BURKE
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State | VA
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Zip | 22015-4208
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Country | US
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Telephone | 703-451-1595
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Fax |
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Provider Business Mailing Address
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Address Line | 4112 MONUMENT CT UNIT 303
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City | FAIRFAX
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State | VA
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Zip | 22033-2881
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Country | US
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Telephone |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28238
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202220032
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License Number State | VA
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