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AGELESS M.D. LLC NPI 1902153992


NPI Information

NPI: 1902153992
Provider Name: AGELESS M.D., LLC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 49D2207798

Address:
2221 N BUCHANAN ST
ARLINGTON, VA
ZIP 22207
Phone: (703) 688-2468
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AGELESS M.D., LLC is a clinic center in Arlington, VA. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). AGELESS M.D., LLC NPI is 1902153992. The provider is registered as an organization entity type.

The provider's business location address is:

2221 N BUCHANAN ST
ARLINGTON, VA
ZIP 22207-526
Phone: (703) 688-2468
Fax: (703) 859-7689

The provider's authorized official is Shai Seyedan .
The authorized official title is Partner and has the following contact phone number (703) 688-2468.

The CLIA number assigned to this NPI record is 49D2207798 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/8/2012 and was last updated on 10/10/2015.


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
1261QC1800XClinic/CenterCorporate Health0101232169VIRGINIANo
2261QV0200XClinic/CenterVA0101232169VIRGINIANo
3261Q00000XClinic/Center0101232169VIRGINIAYes

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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