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SKIN AND LASER SURGERY CENTER NPI 1720277932


NPI Information

NPI: 1720277932
Provider Name: SKIN AND LASER SURGERY CENTER
Classification: Dermatology - 207ND0101X
Entity Type: Organization

Specialization: MOHS-Micrographic Surgery

Address:
8130 BOONE BLVD
SUITE 340
VIENNA, VA
ZIP 22182
Phone: (703) 492-4140
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SKIN AND LASER SURGERY CENTER is a mohs-micrographic surgery dermatology in Vienna, VA. The provider is the highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. SKIN AND LASER SURGERY CENTER NPI is 1720277932. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

8130 BOONE BLVD
SUITE 340
VIENNA, VA
ZIP 22182-666
Phone: (703) 492-4140
Fax: (703) 490-6443

The provider's authorized official is Amir Bajoghli .
The authorized official title is President and has the following contact phone number (703) 492-4140.

The enumeration date for this NPI number is 10/24/2007 and was last updated on 9/24/2008.


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
1207ND0101XDermatologyMOHS-Micrographic Surgery0101053252VIRGINIAYes

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 Other Provider Identifier Issuer
1G45977MEDICARE UPIN
2491664MEDICARE PINDISTRICT OF COLUMBIA
3269480OTHERVIRGINIAANTHEM
4G45977MEDICARE UPINVIRGINIA
5SC0001019MEDICARE PINVIRGINIA
6F502OTHERVIRGINIACAREFIRST
77371099OTHERVIRGINIAAETNA
88297441OTHERVIRGINIACIGNA
9070000348MEDICARE PINVIRGINIA

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: 5/5/2024

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