Provider Demographics
NPI:1417240730
Name:FAGHIH, NIKOO (RPH)
Entity type:Individual
Prefix:
First Name:NIKOO
Middle Name:
Last Name:FAGHIH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6845 ELM ST STE 105
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3822
Mailing Address - Country:US
Mailing Address - Phone:703-338-0828
Mailing Address - Fax:703-388-0826
Practice Address - Street 1:6845 ELM ST STE 105
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3822
Practice Address - Country:US
Practice Address - Phone:703-338-0828
Practice Address - Fax:703-388-0826
Is Sole Proprietor?:No
Enumeration Date:2011-05-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19575183500000X
VA0202209881183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist