Provider Demographics
NPI:1043499205
Name:NIKKHAH ABYANEH, ZOHREH (MD)
Entity type:Individual
Prefix:DR
First Name:ZOHREH
Middle Name:
Last Name:NIKKHAH ABYANEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2026 OPITZ BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3332
Mailing Address - Country:US
Mailing Address - Phone:571-992-8005
Mailing Address - Fax:703-494-3958
Practice Address - Street 1:2026 OPITZ BLVD STE A
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3332
Practice Address - Country:US
Practice Address - Phone:571-992-8005
Practice Address - Fax:703-494-3958
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101255097207V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVVC4070281OtherPALMETTO GBA
VVC4070281OtherMEDICARE
VA1043499205Medicaid
VA13337C25100294OtherMEDICARE