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NPI Code Detail

MEDICARE: TA

MEDICARE: TA
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
1207VE0102XReproductive Endocrinology Physician
2207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1598186256
Entity Type Code : Organization
Provider Name (Legal Business Name) : TA
Provider Business Mailing Address
First Line : 7676 NEW HAMPSHIRE AVE STE 418
Second Line :
City : TAKOMA PARK
State : MD
Zip : 20912-7516
Country : US
Telephone Number : 301-431-0160
Fax Number : 301-431-0163
Provider Business Practice Location Address
First Line : 7676 NEW HAMPSHIRE AVE STE 418
Second Line :
City : TAKOMA PARK
State : MD
Zip : 20912-7516
Country : US
Telephone Number : 301-431-0160
Fax Number : 301-431-0163
Authorized Official
Title or Position : CEO
Name : MR. MARIA JOSE ALLAHYARI
Credential :
Telephone Number : 301-431-0160
Provider Enumeration Date : 12/26/2013
Last Update Date : 12/26/2013

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Directions to “TA ” Practice Location

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