Provider Demographics
NPI:1275262255
Name:BENOMRAN, ASMA (RDN)
Entity type:Individual
Prefix:
First Name:ASMA
Middle Name:
Last Name:BENOMRAN
Suffix:
Gender:
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1288 BROWN CT
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-2000
Mailing Address - Country:US
Mailing Address - Phone:571-397-6551
Mailing Address - Fax:
Practice Address - Street 1:1288 BROWNS MILL CT
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-2000
Practice Address - Country:US
Practice Address - Phone:571-397-6651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-06
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA86304012133VN1004X, 133V00000X
CA133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty