Provider Demographics
NPI:1316303274
Name:ZAREI, MOHSEN
Entity type:Individual
Prefix:
First Name:MOHSEN
Middle Name:
Last Name:ZAREI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11617 COBBLESTONE LANDING CT
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-7538
Mailing Address - Country:US
Mailing Address - Phone:804-363-8003
Mailing Address - Fax:
Practice Address - Street 1:11617 COBBLESTONE LANDING CT
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059-7538
Practice Address - Country:US
Practice Address - Phone:804-363-8003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-07
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202204778183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist