Provider Demographics
NPI:1770923427
Name:GOLRIZ, NASTARAN KHOSHBIN (OD)
Entity type:Individual
Prefix:
First Name:NASTARAN
Middle Name:KHOSHBIN
Last Name:GOLRIZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 F ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20004-1405
Mailing Address - Country:US
Mailing Address - Phone:202-347-7990
Mailing Address - Fax:703-273-6325
Practice Address - Street 1:923 F ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20004-1405
Practice Address - Country:US
Practice Address - Phone:202-347-7990
Practice Address - Fax:703-273-6325
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002254152W00000X
MDTA2356152W00000X
DCOP1000377152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist