Basic Information
Provider Information
NPI: 1811188006
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KAY
FirstName: ATRAC
MiddleName: ARYAN
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3300 GALLOWS RD
Address2:  
City: FALLS CHURCH
State: VA
PostalCode: 220423300
CountryCode: US
TelephoneNumber: 7037764001
FaxNumber: 7037767113
Practice Location
Address1: 3300 GALLOWS RD
Address2:  
City: FALLS CHURCH
State: VA
PostalCode: 220423300
CountryCode: US
TelephoneNumber: 7037764001
FaxNumber: 7037767113
Other Information
ProviderEnumerationDate: 08/05/2007
LastUpdateDate: 06/25/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/29/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400X0101257379VAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
2084N0400X68653GAN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

No ID Information.


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