Ageless M.D., LLC
Organization Active NPI Clinic/Center · Arlington, VA
NPI 1902153992 · NPPES record last updated Oct 10, 2015
Key facts
- NPI
- 1902153992
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- License
- 0101232169 (VA)
- Legal business name
- AGELESS M.D., LLC
- Practice address
- 2221 N Buchanan St
Arlington, VA 22207-2526 - Phone
- (703) 688-2468
- Fax
- (703) 859-7689
- NPI assigned
- Aug 8, 2012
- Organization subpart
- No
Authorized official
- Name
- Mr. Shai Seyedan
- Title
- Partner
- Phone
- (703) 688-2468
Practitioners 2
-
Rajesh Puri, M.D., FAAP, FACPH
-
Derron M Simon, MD
National Provider Directory
Locations
2221 N Buchanan St
Arlington, VA 22207
Phone (703) 688-2468
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | 0101232169 | VA | Yes |
| Corporate Health Clinic/Center | 261QC1800X | 0101232169 | VA | |
| VA Clinic/Center | 261QV0200X | 0101232169 | VA |
Addresses
Primary practice location
2221 N Buchanan St
Arlington, VA 22207-2526
Mailing address
2221 N Buchanan St
Arlington, VA 22207-2526
Phone (703) 688-2468
Other providers in Arlington, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.