Provider Demographics
NPI:1922366012
Name:ADVANCED ARTHRITIS AND RHEUMATOLOGY CARE, PC
Entity Type:Organization
Organization Name:ADVANCED ARTHRITIS AND RHEUMATOLOGY CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIKHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAREBAHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-683-6635
Mailing Address - Street 1:12504 BAY HILL DR
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-2678
Mailing Address - Country:US
Mailing Address - Phone:718-683-6635
Mailing Address - Fax:
Practice Address - Street 1:2324 COLONY CROSSING PL
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-4280
Practice Address - Country:US
Practice Address - Phone:718-683-6635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101246123207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty