Provider Demographics
NPI:1528029261
Name:ZIAI, NILOOFAR (MD)
Entity Type:Individual
Prefix:
First Name:NILOOFAR
Middle Name:
Last Name:ZIAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NILOOFAR
Other - Middle Name:
Other - Last Name:ZIAI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:19441 GOLF VISTA PLAZA
Mailing Address - Street 2:SUITE 320
Mailing Address - City:LANDSDOWNE
Mailing Address - State:VA
Mailing Address - Zip Code:20176
Mailing Address - Country:US
Mailing Address - Phone:703-858-9800
Mailing Address - Fax:703-858-9801
Practice Address - Street 1:19441 GOLF VISTA PLAZA
Practice Address - Street 2:SUITE 320
Practice Address - City:LANDSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176
Practice Address - Country:US
Practice Address - Phone:703-858-9800
Practice Address - Fax:703-858-9801
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101048963207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006301690Medicaid
VAE67254Medicare UPIN
DC017885G96Medicare PIN
VA006301690Medicaid