Provider Demographics
NPI:1275970618
Name:PHYSICIAN SURGICAL ASSISTS, LLC
Entity Type:Organization
Organization Name:PHYSICIAN SURGICAL ASSISTS, LLC
Other - Org Name:PHYSICIAN SURGICAL ASSISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BEHZAD
Authorized Official - Middle Name:
Authorized Official - Last Name:PARVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-777-7477
Mailing Address - Street 1:224-D CORNWALL STREET, NW
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176
Mailing Address - Country:US
Mailing Address - Phone:703-777-7477
Mailing Address - Fax:703-777-2050
Practice Address - Street 1:224-D CORNWALL STREET, NW
Practice Address - Street 2:SUITE 300
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176
Practice Address - Country:US
Practice Address - Phone:703-777-7477
Practice Address - Fax:703-777-2050
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARVA PLASTIC SURGERY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-24
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty