Provider Demographics
NPI:1710329131
Name:MASOOD, AISHA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AISHA
Middle Name:
Last Name:MASOOD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21134 WINDING BROOK SQUARE
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147
Mailing Address - Country:US
Mailing Address - Phone:571-309-0484
Mailing Address - Fax:
Practice Address - Street 1:510 BUTLER AVENUE (PHARMACY SERVICES 119)
Practice Address - Street 2:
Practice Address - City:MARTINGSBURG
Practice Address - State:WV
Practice Address - Zip Code:25405
Practice Address - Country:US
Practice Address - Phone:304-263-0811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-26
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202212252183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist