Provider Demographics
NPI:1477038263
Name:NANAVATY, XAAMA K
Entity Type:Individual
Prefix:
First Name:XAAMA
Middle Name:K
Last Name:NANAVATY
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 1:729 THIMBLE SHOALS BLVD STE 4C
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4217
Mailing Address - Country:US
Mailing Address - Phone:757-597-9510
Mailing Address - Fax:757-597-9514
Practice Address - Street 1:500 RODMAN AVE STE 4
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23707-3100
Practice Address - Country:US
Practice Address - Phone:757-393-6119
Practice Address - Fax:757-393-0681
Is Sole Proprietor?:No
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist