Provider Demographics
NPI:1437271889
Name:KASHANI, ATOOSA (DPM)
Entity Type:Individual
Prefix:
First Name:ATOOSA
Middle Name:
Last Name:KASHANI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14803 HARTLAUB CT
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-2962
Mailing Address - Country:US
Mailing Address - Phone:703-401-6323
Mailing Address - Fax:
Practice Address - Street 1:7540-I LITTLE RIVER TURNPIKE
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-5152
Practice Address - Country:US
Practice Address - Phone:703-750-1124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-05
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103300978213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist