Provider Demographics
NPI:1770018632
Name:HIRA GIRGLANI LLC
Entity Type:Organization
Organization Name:HIRA GIRGLANI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIRGLANI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:845-659-9289
Mailing Address - Street 1:9326 HARVEY RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1639
Mailing Address - Country:US
Mailing Address - Phone:301-576-9564
Mailing Address - Fax:
Practice Address - Street 1:9326 HARVEY RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-1639
Practice Address - Country:US
Practice Address - Phone:301-576-9564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-27
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04532261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD41464245-00Medicaid
MD136820ZAKROtherNOVITAS CMS CONTRACTOR FOR MEDICARE