Provider Demographics
NPI:1093240798
Name:DR ANCHAL DUREJA DPM, LLC
Entity Type:Organization
Organization Name:DR ANCHAL DUREJA DPM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANCHAL
Authorized Official - Middle Name:DUREJA
Authorized Official - Last Name:CHHITWAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-313-8288
Mailing Address - Street 1:23396 SUMMERSTOWN PL
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-2178
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:43810 CENTRAL STATION DR STE 160
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-7210
Practice Address - Country:US
Practice Address - Phone:703-291-6334
Practice Address - Fax:703-291-8285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-01
Last Update Date:2017-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103301177213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty