Provider Demographics
NPI:1194367805
Name:NURUL, AREFIN AH (PT)
Entity Type:Individual
Prefix:
First Name:AREFIN
Middle Name:AH
Last Name:NURUL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 MILL CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-1327
Mailing Address - Country:US
Mailing Address - Phone:757-609-5088
Mailing Address - Fax:
Practice Address - Street 1:301 CLEARFIELD AVE
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4017
Practice Address - Country:US
Practice Address - Phone:757-315-6771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-14
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305206245225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist