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General NPI Number Information
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NPI Number | 1184956120
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL HEALTHCARE ASSOCIATES,INC.
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Dates
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Enumeration Date | 02/02/2010
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Last Update Date | 02/02/2010
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Provider Practice Location Address
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Address Line | 102 ELDEN ST STE. 16
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City | HERNDON
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State | VA
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Zip | 20170-4868
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Country | US
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Telephone | 703-793-6543
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Fax |
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Provider Business Mailing Address
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Address Line | 102 ELDEN ST STE. 16
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City | HERNDON
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State | VA
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Zip | 20170-4868
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Country | US
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Telephone | 703-793-6543
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | NADEEM QAZI
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Credential | MD
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Telephone | 703-793-6543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 0101058418
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License Number State | VA
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