MEDICARE: ZINAT EDJLALI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	146N00000X	Basic Emergency Medical Technician	B202206691	VA

General Provider Information

NPI Number	:	1205706827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZINAT EDJLALI

Provider Business Mailing Address
First Line	:	8095 INNOVATION PARK DR
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22031-4868
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6355 WALKER LN STE 100
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22310-3238
Country	:	US
Telephone Number	:	703-797-6800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2025
Last Update Date	:	11/08/2025

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Directions to “ ZINAT EDJLALI ” Practice Location

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