Individual ProviderMarylynn AminrazaviNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2150 Pennsylvania Ave NW, Suite 3-438, Washington, DC 20037-3201(202) 741-2283PECOS EnrollmentBased on the most recent information from CMS, provider Marylynn Aminrazavi is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1750573242Provider TypeIndividualFull NameAminrazavi, MarylynnTitleMrs.CredentialNPGenderFemaleSole ProprietorNoEnumeration Date8/17/2007Last Updated12/13/2011Contact InformationPractice LocationPractice Address2150 Pennsylvania Ave NW, Suite 3-438, Washington, DC 20037-3201Phone(202) 741-2283Fax(202) 741-2285Mailing LocationMailing Address2150 Pennsylvania Ave NW, Suite 3-438, Washington, DC 20037-3201Phone(202) 741-2283Fax(202) 741-2285Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseRN1025151District of ColumbiaCode363LF0000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense0024167494Virginia