Provider Demographics
NPI:1225550742
Name:AZIZALDIN, AREZOU (OD)
Entity type:Individual
Prefix:
First Name:AREZOU
Middle Name:
Last Name:AZIZALDIN
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 1:44727 BRIMFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-5920
Mailing Address - Country:US
Mailing Address - Phone:571-385-4600
Mailing Address - Fax:703-729-1380
Practice Address - Street 1:44727 BRIMFIELD DR
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5920
Practice Address - Country:US
Practice Address - Phone:571-385-4600
Practice Address - Fax:703-729-1380
Is Sole Proprietor?:No
Enumeration Date:2017-07-17
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002602152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist