Provider Demographics
NPI:1275303885
Name:SAFARI, KHATIRA (DAC)
Entity Type:Individual
Prefix:
First Name:KHATIRA
Middle Name:
Last Name:SAFARI
Suffix:
Gender:F
Credentials:DAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15125 WASHINGTON ST STE 216
Mailing Address - Street 2:
Mailing Address - City:HAYMARKET
Mailing Address - State:VA
Mailing Address - Zip Code:20169-4916
Mailing Address - Country:US
Mailing Address - Phone:703-753-2923
Mailing Address - Fax:
Practice Address - Street 1:15125 WASHINGTON ST STE 216
Practice Address - Street 2:
Practice Address - City:HAYMARKET
Practice Address - State:VA
Practice Address - Zip Code:20169-4916
Practice Address - Country:US
Practice Address - Phone:703-753-2923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist