| Personic Neuropsych Pllc | |
|
7611 Little River Tpke Ste 101w Annandale VA 22003-2611 | |
| (571) 556-9777 | |
| (215) 933-6837 |
| Full Name | Personic Neuropsych Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7611 Little River Tpke Ste 101w, Annandale, Virginia |
| Authorized Official Name and Position | Syed Naqvi (OWNER) |
| Authorized Official Contact | 8032202234 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Personic Neuropsych Pllc 7611 Little River Tpke Ste 101w Annandale VA 22003-2611 Ph: (803) 220-2234 | Personic Neuropsych Pllc 7611 Little River Tpke Ste 101w Annandale VA 22003-2611 Ph: (571) 556-9777 |
| NPI Number | 1083342596 |
|---|---|
| Provider Enumeration Date | 08/11/2022 |
| Last Update Date | 10/27/2022 |
| Certification Date | 10/27/2022 |
| Medicare PECOS PAC ID | 8123496056 |
|---|---|
| Medicare Enrollment ID | O20221123002318 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083342596 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Amar A Mukhtar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346697760 PECOS PAC ID: 5092009563 Enrollment ID: I20200903002670 |
| Provider Name | Jade Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225629785 PECOS PAC ID: 2860800281 Enrollment ID: I20210422002272 |
| Provider Name | Omer Haroon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972855104 PECOS PAC ID: 0547565970 Enrollment ID: I20221116003417 |
| Provider Name | Sulman Mirza |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699036012 PECOS PAC ID: 8820238652 Enrollment ID: I20221117002637 |
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