OrganizationActive
Avicenna Health & Medical LLC
NPI 1083150239 · Internal Medicine Physician · Reston, VA
Provider details
- NPI number
- 1083150239
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Malika Manyam, President(810) 341-3295
- License
- 0101251555 (VA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(70/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1860 Town Center Dr Ste 340
Reston, VA 20190-5912
Phone: (703) 943-7475
Street-level locationGet directions
Mailing address
Po Box 2695
Reston, VA 20195-0695
Registry dates
- Enumerated
- 2017-01-11
- Last updated
- 2019-04-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.