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General NPI Number Information
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NPI Number | 1083342596
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Entity Type | Organization
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Legal Business Name | PERSONIC NEUROPSYCH PLLC
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Dates
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Enumeration Date | 08/11/2022
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | 7611 LITTLE RIVER TPKE STE 101W
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City | ANNANDALE
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State | VA
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Zip | 22003-2611
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Country | US
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Telephone | 571-556-9777
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Fax | 215-933-6837
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Provider Business Mailing Address
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Address Line | 7611 LITTLE RIVER TPKE STE 101W
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City | ANNANDALE
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State | VA
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Zip | 22003-2611
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Country | US
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Telephone | 803-220-2234
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Fax | 215-933-6837
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Authorized Official
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Title or Position | OWNER
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Name | SYED NAQVI
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Credential | DO
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Telephone | 803-220-2234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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