Provider Demographics
NPI:1588429203
Name:KESHISHIAN, ARIS
Entity type:Individual
Prefix:
First Name:ARIS
Middle Name:
Last Name:KESHISHIAN
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 1:21085 ROTUNDA TER
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-2445
Mailing Address - Country:US
Mailing Address - Phone:443-618-6339
Mailing Address - Fax:
Practice Address - Street 1:21085 ROTUNDA TER
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-2445
Practice Address - Country:US
Practice Address - Phone:443-618-6339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25017183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist