Individual
MAHASTI KHALESSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5110 NICHOLSON LANE, KENSINGTON, MD 20895
(301) 881-0646
(301) 881-2198
Mailing address
8811 TUCKERMAN LN, POTOMAC, MD 20854-3165
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13297
MD
Other
Enumeration date
07/12/2018
Last updated
07/12/2018
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