Provider Demographics
NPI:1477026227
Name:PARVA PLASTIC RECONSTRUCTIVE SURGERY LLC
Entity Type:Organization
Organization Name:PARVA PLASTIC RECONSTRUCTIVE SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:BEHZAD
Authorized Official - Middle Name:
Authorized Official - Last Name:PARVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACS
Authorized Official - Phone:703-777-7477
Mailing Address - Street 1:224D CORNWALL ST NW STE 300
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-2704
Mailing Address - Country:US
Mailing Address - Phone:703-777-7477
Mailing Address - Fax:
Practice Address - Street 1:224D CORNWALL ST NW STE 300
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-2704
Practice Address - Country:US
Practice Address - Phone:703-777-7477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-04
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty