Doctor Name: | JAMILA NICOLE H MYSOREWALA |
NPI Number: | 1386084994 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 1651 Old Meadow Rd Suite 600 Mc Lean, VA - 221024311 |
Business Phone Number: | 3059263811 |
Business Fax Number: | |
Mailing Address: | 4200 N Carlin Springs Rd, Apt 600 ARLINGTON |
State: | VA |
Postal Code: | 222032089 |
Phone Number: | 3059263811 |
Fax Number: | |
NPI Enumeration Date: | 06/27/2013 |
NPI Last Update Date: | 11/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |