Provider Demographics
NPI:1225766405
Name:BHATTI, AZIZ FATIMA
Entity Type:Individual
Prefix:
First Name:AZIZ
Middle Name:FATIMA
Last Name:BHATTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21746 CYPRESS VALLEY TER
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-7209
Mailing Address - Country:US
Mailing Address - Phone:703-944-2681
Mailing Address - Fax:
Practice Address - Street 1:24801 PINEBROOK RD STE 200
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20152-4113
Practice Address - Country:US
Practice Address - Phone:703-722-2525
Practice Address - Fax:703-327-6708
Is Sole Proprietor?:No
Enumeration Date:2022-08-15
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
VA2305215363225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist