Provider Demographics
NPI:1912874314
Name:NOVA MJ HEALTH PLLC
Entity type:Organization
Organization Name:NOVA MJ HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:DR
Authorized Official - First Name:YEGANEH
Authorized Official - Middle Name:
Authorized Official - Last Name:JALAEIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:571-200-3284
Mailing Address - Street 1:8296 OLD COURTHOUSE RD STE C
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3852
Mailing Address - Country:US
Mailing Address - Phone:571-200-3284
Mailing Address - Fax:571-376-6555
Practice Address - Street 1:8296 OLD COURTHOUSE RD STE C
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3852
Practice Address - Country:US
Practice Address - Phone:571-200-3284
Practice Address - Fax:571-376-6555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty