MEDICARE: AVICENNA ACUPUNCTURE &HERBAL MEDICINE

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	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1477481117
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVICENNA ACUPUNCTURE &HERBAL MEDICINE

Provider Business Mailing Address
First Line	:	10220 RIVER RD STE 206
Second Line	:
City	:	POTOMAC
State	:	MD
Zip	:	20854-4911
Country	:	US
Telephone Number	:	240-422-0756
Fax Number	:

Provider Business Practice Location Address
First Line	:	10220 RIVER RD STE 206
Second Line	:
City	:	POTOMAC
State	:	MD
Zip	:	20854-4911
Country	:	US
Telephone Number	:	240-422-0756
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. FARAHNAZ BEHROOZIESFAHANI
Credential	:	DAC
Telephone Number	:	240-422-0756

Provider Enumeration Date	:	05/12/2026
Last Update Date	:	05/12/2026

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