Basic Information
Provider Information
NPI: 1265678957
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHAH
FirstName: PARINI
MiddleName: PARIKH
NamePrefix: MRS.
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3620 JOSEPH SIEWICK DRIVE
Address2: SUITE 406
City: FAIRFAX
State: VA
PostalCode: 22033
CountryCode: US
TelephoneNumber: 7033598640
FaxNumber: 7035916105
Practice Location
Address1: 3620 JOSEPH SIEWICK DRIVE
Address2: SUITE 406
City: FAIRFAX
State: VA
PostalCode: 22033
CountryCode: US
TelephoneNumber: 7033598640
FaxNumber: 7035916105
Other Information
ProviderEnumerationDate: 12/30/2008
LastUpdateDate: 06/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/03/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X0110002937VAY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


Home