Basic Information
Provider Information
NPI: 1326014853
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MIGLANI
FirstName: JASDEEP
MiddleName: S
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7969 ASHTON AVE
Address2:  
City: MANASSAS
State: VA
PostalCode: 201092885
CountryCode: US
TelephoneNumber: 7037927800
FaxNumber: 7037925699
Practice Location
Address1: 7969 ASHTON AVE
Address2:  
City: MANASSAS
State: VA
PostalCode: 201092885
CountryCode: US
TelephoneNumber: 7037927800
FaxNumber: 7037925699
Other Information
ProviderEnumerationDate: 02/24/2006
LastUpdateDate: 02/18/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/18/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X042.00015740VTN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
2084P0800X0101-231416VAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

ID Information
IDTypeStateIssuerDescription
00494524705VA MEDICAID


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