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General NPI Number Information
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NPI Number | 1508252784
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Entity Type | Individual
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Provider Name | MOHAMMAD-ALI YAZDANI ABYANEH
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Gender | Male
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Dates
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Enumeration Date | 04/14/2015
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 2296 OPITZ BLVD STE 250
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City | WOODBRIDGE
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State | VA
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Zip | 22191-3345
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Country | US
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Telephone | 703-844-4267
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Fax | 703-982-7238
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Provider Business Mailing Address
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Address Line | 1729 BURRSTONE RD
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City | NEW HARTFORD
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State | NY
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Zip | 13413-1001
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Country | US
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Telephone | 315-798-1832
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Fax | 315-798-1432
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 299230
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 0101286129
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License Number State | VA
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