Provider Demographics
NPI:1083216634
Name:ZIJERDI, IGIN (DC)
Entity Type:Individual
Prefix:DR
First Name:IGIN
Middle Name:
Last Name:ZIJERDI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 ELDEN ST STE 12
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-4839
Mailing Address - Country:US
Mailing Address - Phone:703-581-8999
Mailing Address - Fax:
Practice Address - Street 1:102 ELDEN ST STE 12
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4839
Practice Address - Country:US
Practice Address - Phone:703-581-8999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13263111N00000X
VA0104557711111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor