Provider Demographics
NPI:1902164882
Name:NAVID MOSTOFI, MD, PC
Entity Type:Organization
Organization Name:NAVID MOSTOFI, MD, PC
Other - Org Name:VIENNA NEUROLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSTOFI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-210-8849
Mailing Address - Street 1:PO BOX 11922
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-9122
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:380 MAPLE AVE W
Practice Address - Street 2:SUITE 206
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-5620
Practice Address - Country:US
Practice Address - Phone:703-652-0948
Practice Address - Fax:703-542-3584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012486832084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty