Provider Demographics
NPI:1164438909
Name:ESMAILI, HAYDEH F (MD)
Entity Type:Individual
Prefix:MS
First Name:HAYDEH
Middle Name:F
Last Name:ESMAILI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 BUSINESS PARK DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-6533
Mailing Address - Country:US
Mailing Address - Phone:757-466-3336
Mailing Address - Fax:757-455-5750
Practice Address - Street 1:2470 PRUDEN BLVD
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434
Practice Address - Country:US
Practice Address - Phone:757-539-1503
Practice Address - Fax:757-539-0107
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101039180174400000X
VA101039180174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA080387OtherSENTARA
VA541493432OtherMAMSI
VA541493432OtherWORK COMP
VA541493432OtherUSHEALTHCARE
VA038574000OtherMAGELLAN BEHAVIORAL
VA541493432OtherCHAMPUS
VAAETNAOther541493432
VA099354OtherBCBS09 FED
VA541493432OtherCOMMERICAL
VA541493432OtherDEPT OF REHABS
VA541493432OtherVHN
VA54149342OtherCIGNA
NC890539CMedicaid
VA007153619Medicaid
NC541493432OtherBCBS
NC541493432OtherBCBS
VA541493432OtherVHN