Provider Demographics
NPI:1619680220
Name:SAMANY, PEZHMAN (DC)
Entity Type:Individual
Prefix:DR
First Name:PEZHMAN
Middle Name:
Last Name:SAMANY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5101B BACKLICK RD
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-6063
Mailing Address - Country:US
Mailing Address - Phone:703-333-5022
Mailing Address - Fax:
Practice Address - Street 1:5101B BACKLICK RD
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-6063
Practice Address - Country:US
Practice Address - Phone:703-333-5022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557863111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor