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Contact Information

MARYAM N NICKSOLAT
8370 GREENSBORO DR APT 814
MCLEAN, VA22102
 Phone: 703-200-7727
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for MARYAM N NICKSOLAT · (Female)

NPI Number 1215027545
Status Active
Credentials
Entity Individual
Enumeration date 10/16/2006
Last updated 04/24/2017 - About 9 years ago
Sole proprietor 1 No
Identifiers
  • VA License # 0110001340
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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