AVICENNA MEDICAL CLINIC INC. NPI 1285749978

NPI Information

NPI: 1285749978
Provider Name: AVICENNA MEDICAL CLINIC, INC.
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
50 S PICKETT STREET
SUITE # 221
ALEXANDRIA, VA
ZIP 22304
Phone: (703) 751-7331
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AVICENNA MEDICAL CLINIC, INC. is a health service clinic center in Alexandria, VA. AVICENNA MEDICAL CLINIC, INC. NPI is 1285749978. The provider is registered as an organization entity type.

The provider's business location address is:

50 S PICKETT STREET
SUITE # 221
ALEXANDRIA, VA
ZIP 22304-922
Phone: (703) 751-7331
Fax: (703) 751-2524

The provider's authorized official is Satar Ahmadi .
The authorized official title is Principal and has the following contact phone number (703) 751-7331.

The enumeration date for this NPI number is 8/20/2006 and was last updated on 11/3/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service	0101041949	VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	767039	MEDICARE PIN	VIRGINIA
2	005623626	MEDICAID	VIRGINIA
3	F19401	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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