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General NPI Number Information
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NPI Number | 1265344881
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Entity Type | Organization
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Legal Business Name | POET MEDICAL LLC
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Dates
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Enumeration Date | 09/18/2026
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Last Update Date | 09/18/2026
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Provider Practice Location Address
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Address Line | 23710 SCHOOLER PLZ STE 2023
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City | ASHBURN
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State | VA
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Zip | 20148-1920
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Country | US
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Telephone | 124-062-6792
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Fax |
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Provider Business Mailing Address
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Address Line | 23710 SCHOOLER PLZ STE 2023
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City | ASHBURN
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State | VA
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Zip | 20148-1920
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Country | US
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Telephone | 124-062-6792
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NYSA MARINDA PAYSOUR
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Credential |
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Telephone | 124-062-6792
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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