Provider Demographics
NPI:1134427453
Name:ORTHOPAEDIC & SPINE SURGERY INSTITUTE PLLC
Entity type:Organization
Organization Name:ORTHOPAEDIC & SPINE SURGERY INSTITUTE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSHIRFAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-729-4692
Mailing Address - Street 1:19465 DEERFIELD AVE
Mailing Address - Street 2:SUITE 207 & 307
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-1701
Mailing Address - Country:US
Mailing Address - Phone:703-729-4692
Mailing Address - Fax:703-729-4693
Practice Address - Street 1:19465 DEERFIELD AVE
Practice Address - Street 2:SUITE 207 & 307
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-1701
Practice Address - Country:US
Practice Address - Phone:703-729-4692
Practice Address - Fax:703-729-4693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty