1790771541 NPI number — DR. SAADIA ALIZAI M.D.

Table of content: IRIS LAU YEE SOULET (NPI 1033527510)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790771541 NPI number — DR. SAADIA ALIZAI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALIZAI
Provider First Name:
SAADIA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790771541
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/24/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14888 W 57TH DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GOLDEN
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80403-3002
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-420-8311
Provider Business Mailing Address Fax Number:
202-354-5074

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5530 WISCONSIN AVE STE 965
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHEVY CHASE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20815-4325
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-420-8311
Provider Business Practice Location Address Fax Number:
202-354-5074
Provider Enumeration Date:
09/26/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084F0202X , with the licence number:  MD035864 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X , with the licence number: MD035864 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X , with the licence number: DR.0069829 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X , with the licence number: D0054605 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4072251 00 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".