1730565607 NPI number — MASOODA IBRAHIMI NAIM CRNP-F

Table of content: PAUL YURFEST (NPI 1710033261)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730565607 NPI number — MASOODA IBRAHIMI NAIM CRNP-F

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NAIM
Provider First Name:
MASOODA
Provider Middle Name:
IBRAHIMI
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNP-F
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
IBRAHIMI
Provider Other First Name:
MASOODA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1730565607
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11350 MCCORMICK RD
Provider Second Line Business Mailing Address:
EXECUTIVE PLAZA 1, SUITE 501
Provider Business Mailing Address City Name:
HUNT VALLEY
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21031-1002
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-881-7246
Provider Business Mailing Address Fax Number:
301-881-2449

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11921 ROCKVILLE PIKE
Provider Second Line Business Practice Location Address:
SUITE 505
Provider Business Practice Location Address City Name:
ROCKVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20852-2737
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-881-7246
Provider Business Practice Location Address Fax Number:
301-881-2449
Provider Enumeration Date:
08/03/2015

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: 363LF0000X , with the licence number:  AC001551 , 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)





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