SEDDIGHEH A. FEISEE MD PC
Assisted Living Facility
Burke, Virginia
Provider NPI: 1588677959
Organization Information:Organization Name: SEDDIGHEH A. FEISEE MD PC
Practice Location:
9554 OLD KEENE MILL RD BURKE, VA 22015 US
Tel: 703-569-4133 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
9554 OLD KEENE MILL RD BURKE, VA 22015 US
Tel: 703-569-4133 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 310400000X | Nursing & Custodial Care Facilities Assisted Living Facility | VA | 0101025770 |
Y | 207R00000X | Physicians Internal Medicine | VA | 0101025770 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
010315336 | VA | 05 | |
CLINICAL LABARATORY IMPROVEMENT AMENDMENTS (CLIA) | 49D0716392 | VA | 01 |
010090326 | VA | 05 | |
006060277 | VA | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin