Provider Demographics
NPI:1326580267
Name:GUPTA, AASHEE (OTR/L)
Entity Type:Individual
Prefix:
First Name:AASHEE
Middle Name:
Last Name:GUPTA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21170 ASHBY PONDS BLVD
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-6128
Mailing Address - Country:US
Mailing Address - Phone:703-581-7141
Mailing Address - Fax:
Practice Address - Street 1:21170 ASHBY PONDS BLVD
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-6128
Practice Address - Country:US
Practice Address - Phone:703-581-7141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-09
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119004119225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA495416Medicare Oscar/Certification
VA496734Medicare Oscar/Certification