| Persona Payments Llc | |
|
1953 Gallows Rd Ste 120 Tysons Corner VA 22182-4009 | |
| (703) 291-0021 | |
| Not Available |
| Full Name | Persona Payments Llc |
|---|---|
| Speciality | Internal Medicine - Obesity Medicine |
| Location | 1953 Gallows Rd Ste 120, Tysons Corner, Virginia |
| Authorized Official Name and Position | Kavan Shaban (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7034055338 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Persona Payments Llc 8120 Woodmont Ave Ste 180 Bethesda MD 20814-2757 Ph: (703) 405-5338 | Persona Payments Llc 1953 Gallows Rd Ste 120 Tysons Corner VA 22182-4009 Ph: (703) 291-0021 |
| NPI Number | 1326760497 |
|---|---|
| Provider Enumeration Date | 09/15/2022 |
| Last Update Date | 11/10/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326760497 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RB0002X | Internal Medicine - Obesity Medicine | (* (Not Available)) | Primary |