Provider Demographics
NPI:1568114080
Name:SERAJ, ZAKIA NAZIMA
Entity Type:Individual
Prefix:
First Name:ZAKIA
Middle Name:NAZIMA
Last Name:SERAJ
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 1:3790 LYNDHURST DR APT 202
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-3729
Mailing Address - Country:US
Mailing Address - Phone:517-974-3181
Mailing Address - Fax:
Practice Address - Street 1:3790 LYNDHURST DR APT 202
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-3729
Practice Address - Country:US
Practice Address - Phone:517-974-3181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health