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General NPI Number Information
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NPI Number | 1699876615
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Entity Type | Organization
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Legal Business Name | PODIATRY CENTER-ANNANDALE PC
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 06/17/2013
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Provider Practice Location Address
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Address Line | 7540 LITTLE RIVER TPKE SUITE I
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City | ANNANDALE
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State | VA
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Zip | 22003-2839
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Country | US
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Telephone | 703-750-1124
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Fax | 703-750-2043
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Provider Business Mailing Address
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Address Line | 7540 LITTLE RIVER TPKE SUITE I
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City | ANNANDALE
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State | VA
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Zip | 22003-2839
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Country | US
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Telephone | 703-750-1124
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Fax | 703-750-2043
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. ATOOSA KASHANI
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Credential | D.P.M
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Telephone | 703-750-1124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0103300978
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License Number State | VA
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