Provider Demographics
NPI:1104289669
Name:ZUHDI M. DAJANI CARDIOLOGY-INTERNAL MEDICINE, LLC
Entity type:Organization
Organization Name:ZUHDI M. DAJANI CARDIOLOGY-INTERNAL MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZUHDI
Authorized Official - Middle Name:
Authorized Official - Last Name:DAJANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-590-0097
Mailing Address - Street 1:2225 WOODFORD RD
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-5084
Mailing Address - Country:US
Mailing Address - Phone:814-590-0097
Mailing Address - Fax:
Practice Address - Street 1:2225 WOODFORD RD
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-5084
Practice Address - Country:US
Practice Address - Phone:814-590-0097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-01
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101040149261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA030709Medicare UPIN