| Park Avenue Medical Group, P.c. | |
|
313 Park Ave Suite 202 Falls Church VA 22046-3327 | |
| (703) 533-3010 | |
| (703) 538-4316 |
| Full Name | Park Avenue Medical Group, P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 313 Park Ave, Falls Church, Virginia |
| Authorized Official Name and Position | Firoozeh Hosseini Shahidi (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7035333010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Avenue Medical Group, P.c. 313 Park Ave Suite 202 Falls Church VA 22046-3327 Ph: (703) 533-3010 | Park Avenue Medical Group, P.c. 313 Park Ave Suite 202 Falls Church VA 22046-3327 Ph: (703) 533-3010 |
| NPI Number | 1881862472 |
|---|---|
| Provider Enumeration Date | 02/15/2008 |
| Last Update Date | 02/15/2008 |
| Medicare PECOS PAC ID | 5092900688 |
|---|---|
| Medicare Enrollment ID | O20101109000511 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881862472 | NPI | - | NPPES |
| 6006892 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Firoozeh Hosseini Shahidi |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1619058674 PECOS PAC ID: 7113112798 Enrollment ID: I20101109000460 |
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