1972715746 NPI number — MR. MOHAMED FARID RAMADAN LICENSE PHYSICAL THE

Table of content: MR. MOHAMED FARID RAMADAN LICENSE PHYSICAL THE (NPI 1972715746)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972715746 NPI number — MR. MOHAMED FARID RAMADAN LICENSE PHYSICAL THE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAMADAN
Provider First Name:
MOHAMED
Provider Middle Name:
FARID
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LICENSE PHYSICAL THE
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972715746
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9908 LAKEPOINTE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BURKE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22015
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-503-1284
Provider Business Mailing Address Fax Number:
703-503-1284

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5501 BACKLICK ROAD
Provider Second Line Business Practice Location Address:
ALLIANCE REHAB & PHYSICAL THERAPY
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22051
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-750-1204
Provider Business Practice Location Address Fax Number:
703-750-1206
Provider Enumeration Date:
05/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  2306601454 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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