Organization
PARK AVENUE MEDICAL GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FIROOZEH HOSSEINI SHAHIDI M.D. (MEDICAL DIRECTOR)
(703) 533-3010
Entity
Organization
Contact information
Practice address
313 PARK AVE, SUITE 202, FALLS CHURCH, VA 22046-3327
(703) 533-3010
(703) 538-4316
Mailing address
313 PARK AVE, SUITE 202, FALLS CHURCH, VA 22046-3327
(703) 533-3010
(703) 538-4316
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6006892
—
VA
Enumeration date
02/15/2008
Last updated
02/15/2008
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