Provider Demographics
NPI:1598186256
Name:TA
Entity Type:Organization
Organization Name:TA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARIA JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLAHYARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-431-0160
Mailing Address - Street 1:7676 NEW HAMPSHIRE AVE STE 418
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-7516
Mailing Address - Country:US
Mailing Address - Phone:301-431-0160
Mailing Address - Fax:301-431-0163
Practice Address - Street 1:7676 NEW HAMPSHIRE AVE STE 418
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-7516
Practice Address - Country:US
Practice Address - Phone:301-431-0160
Practice Address - Fax:301-431-0163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-26
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Multi-Specialty