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General NPI Number Information
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NPI Number | 1689351991
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Entity Type | Individual
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Provider Name | ARASH EIDIZADEH CRNA
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Gender | Male
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Dates
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Enumeration Date | 06/28/2023
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 44045 RIVERSIDE PKWY
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City | LEESBURG
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State | VA
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Zip | 20176-5101
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Country | US
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Telephone | 703-858-6490
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Fax | 571-291-9263
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Provider Business Mailing Address
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Address Line | 432 WEST CT NW
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City | VIENNA
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State | VA
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Zip | 22180-4183
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Country | US
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Telephone |
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Fax |
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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 | 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 #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 0024192518
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License Number State | VA
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