Basic Information
| Provider Information | |||||||||
| NPI: | 1861403156 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ASHAI | ||||||||
| FirstName: | AFSHAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SARAF | ||||||||
| OtherFirstName: | AFSHAN | ||||||||
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| OtherCredential: | MBBS | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3801 LIGHTFOOT STREET | ||||||||
| Address2: | APT #306 | ||||||||
| City: | CHANTILLY | ||||||||
| State: | VA | ||||||||
| PostalCode: | 20151 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5405209770 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7969 ASHTON AVENUE | ||||||||
| Address2: | |||||||||
| City: | MANASSAS | ||||||||
| State: | VA | ||||||||
| PostalCode: | 20109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7037927800 | ||||||||
| FaxNumber: | 7037925699 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2006 | ||||||||
| LastUpdateDate: | 01/07/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 010238605 | VA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 292548 | 01 | VA | AMERIGROUP | OTHER | 171705 | 01 | VA | BLUE CROSS BLUE SHIELD | OTHER | 004945247 | 05 | VA | MEDICAID |