Individual
DR. MANDANA NASIRI MANESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
43330 JUNCTION PLZ STE 120, ASHBURN, VA 20147-3407
(703) 663-4290
(888) 920-2640
Mailing address
43330 JUNCTION PLZ STE 120, ASHBURN, VA 20147-3407
(703) 663-4290
(888) 920-2640
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618002744
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861050650
SOUL NPI NUMBER
—
Enumeration date
06/05/2019
Last updated
04/25/2023
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