Provider Demographics
NPI:1497714174
Name:GIRMAI, AZEIB (ANP)
Entity Type:Individual
Prefix:
First Name:AZEIB
Middle Name:
Last Name:GIRMAI
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8919 MOUNTAIN ASH DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22153-2168
Mailing Address - Country:US
Mailing Address - Phone:703-343-5503
Mailing Address - Fax:
Practice Address - Street 1:1015 15TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-2605
Practice Address - Country:US
Practice Address - Phone:703-343-5503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC966617363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P69897Medicare UPIN
DC010478M53Medicare PIN