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Organization

SKIN INSTITUTE OF VIRGINIA, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FARHAAD RAHMAN RIYAZ MD (CEO)
(703) 615-6569
Entity
Organization

Contact information

Practice address
19455 DEERFIELD AVE STE 311, LANSDOWNE, VA 20176-8102
(703) 723-9751
Mailing address
7712 FALSTAFF RD, MC LEAN, VA 22102-2723
(703) 615-6569

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
207ND0900X
Dermatopathology Physician
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
207NS0135X
Procedural Dermatology Physician

Other

Enumeration date
11/06/2019
Last updated
11/06/2019
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