Provider Demographics
NPI:1285143008
Name:PSYCHIATRIC ASSOCIATES OF NORTHERN VIRGINIA
Entity type:Organization
Organization Name:PSYCHIATRIC ASSOCIATES OF NORTHERN VIRGINIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:W H
Authorized Official - Last Name:RIZVI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-610-2615
Mailing Address - Street 1:22038 AUCTION BARN DR
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20148-4110
Mailing Address - Country:US
Mailing Address - Phone:443-610-2615
Mailing Address - Fax:
Practice Address - Street 1:4229 LAFAYETTE CENTER DR STE 1760
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-1267
Practice Address - Country:US
Practice Address - Phone:443-610-2615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-25
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01011023502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty