Provider Demographics
NPI: | 1518647163 |
---|---|
Name: | NATURAL BEAUTY AESTHETIX LLC |
Entity Type: | Organization |
Organization Name: | NATURAL BEAUTY AESTHETIX LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER/MEDICAL DIRECTOR |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | SAHAR |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | TAYLOR |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | FNP-C |
Authorized Official - Phone: | 267-495-7118 |
Mailing Address - Street 1: | 10770 COLUMBIA PIKE STE 300 |
Mailing Address - Street 2: | |
Mailing Address - City: | SILVER SPRING |
Mailing Address - State: | MD |
Mailing Address - Zip Code: | 20901-4439 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 267-495-7118 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 8730 GEORGIA AVE STE 400BF |
Practice Address - Street 2: | |
Practice Address - City: | SILVER SPRING |
Practice Address - State: | MD |
Practice Address - Zip Code: | 20910-3604 |
Practice Address - Country: | US |
Practice Address - Phone: | 240-704-0929 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-07-19 |
Last Update Date: | 2023-07-19 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Single Specialty |