Provider Demographics
NPI:1396815031
Name:AMIRY, SYED
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:
Last Name:AMIRY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 TOWN CENTER DR STE 212
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-3238
Mailing Address - Country:US
Mailing Address - Phone:703-766-2220
Mailing Address - Fax:571-323-1486
Practice Address - Street 1:1800 TOWN CENTER DR STE 212
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3238
Practice Address - Country:US
Practice Address - Phone:703-766-2220
Practice Address - Fax:571-323-1486
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102201287207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H28213Medicare UPIN
VAG01227Medicare ID - Type Unspecified