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Organization

TAHAYYA A.M ANSARI

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. TAHAYYA A M ANSARI PA (MEDICAL)
(804) 734-6262
Entity
Organization

Contact information

Practice address
700 24TH ST, FORT LEE, VA 23801-1716
(804) 734-9942
(804) 734-1008
Mailing address
700 24TH ST, FORT LEE, VA 23801-1716
(804) 734-9942
(804) 734-1008

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
01/04/2006
Last updated
05/09/2011
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