Provider Demographics
NPI:1144644089
Name:DASTYAR, ARMETA (MAC, LAC)
Entity type:Individual
Prefix:MISS
First Name:ARMETA
Middle Name:
Last Name:DASTYAR
Suffix:
Gender:F
Credentials:MAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11601 PRINCE ALBERT TER
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-4115
Mailing Address - Country:US
Mailing Address - Phone:301-428-0249
Mailing Address - Fax:
Practice Address - Street 1:11601 PRINCE ALBERT TER
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-4115
Practice Address - Country:US
Practice Address - Phone:301-428-0249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02119171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist