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General NPI Number Information
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NPI Number | 1285143008
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Entity Type | Organization
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Legal Business Name | PSYCHIATRIC ASSOCIATES OF NORTHERN VIRGINIA
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Dates
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Enumeration Date | 09/25/2017
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Last Update Date | 10/03/2017
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Provider Practice Location Address
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Address Line | 4229 LAFAYETTE CENTER DR STE 1760
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City | CHANTILLY
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State | VA
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Zip | 20151-1267
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Country | US
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Telephone | 443-610-2615
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Fax |
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Provider Business Mailing Address
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Address Line | 22038 AUCTION BARN DR
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City | ASHBURN
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State | VA
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Zip | 20148-4110
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Country | US
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Telephone | 443-610-2615
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | DR. SYED W H RIZVI
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Credential | MD
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Telephone | 443-610-2615
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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 | 0101102350
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License Number State | VA
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