Provider Demographics
NPI:1497987317
Name:LAJEVARDI, NAHAL SAADAT (PT)
Entity Type:Individual
Prefix:
First Name:NAHAL
Middle Name:SAADAT
Last Name:LAJEVARDI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11501 VALE RD
Mailing Address - Street 2:
Mailing Address - City:OAKTON
Mailing Address - State:VA
Mailing Address - Zip Code:22124-1336
Mailing Address - Country:US
Mailing Address - Phone:703-391-0533
Mailing Address - Fax:703-242-3993
Practice Address - Street 1:2863 HUNTER MILL RD
Practice Address - Street 2:
Practice Address - City:OAKTON
Practice Address - State:VA
Practice Address - Zip Code:22124-1702
Practice Address - Country:US
Practice Address - Phone:703-242-3667
Practice Address - Fax:703-242-3993
Is Sole Proprietor?:No
Enumeration Date:2009-08-11
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305006527225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist