Provider Demographics
NPI:1558793224
Name:NOORJAHAN, MAHSHID
Entity Type:Individual
Prefix:
First Name:MAHSHID
Middle Name:
Last Name:NOORJAHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2802 LEE OAKS PL APT 303
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-7347
Mailing Address - Country:US
Mailing Address - Phone:301-272-4414
Mailing Address - Fax:
Practice Address - Street 1:403 REDLAND BLVD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-5234
Practice Address - Country:US
Practice Address - Phone:301-990-4350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20551183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist