Provider Demographics
NPI:1164288122
Name:SADEGHI, PARICHEHR
Entity Type:Individual
Prefix:
First Name:PARICHEHR
Middle Name:
Last Name:SADEGHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 GEORGIA AVE NW APT 444
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-2682
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6103 BALTIMORE AVE STE T1
Practice Address - Street 2:
Practice Address - City:RIVERDALE PARK
Practice Address - State:MD
Practice Address - Zip Code:20737-1966
Practice Address - Country:US
Practice Address - Phone:301-277-2779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant