Provider Demographics
NPI:1518924349
Name:HETFIARCHCHI, NAVIN (ATC CSCS PES)
Entity Type:Individual
Prefix:MR
First Name:NAVIN
Middle Name:
Last Name:HETFIARCHCHI
Suffix:
Gender:M
Credentials:ATC CSCS PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2535 13TH ST NW
Mailing Address - Street 2:105
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009
Mailing Address - Country:US
Mailing Address - Phone:202-550-6757
Mailing Address - Fax:
Practice Address - Street 1:1112 16TH ST NW
Practice Address - Street 2:STE 200
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036
Practice Address - Country:US
Practice Address - Phone:202-223-1737
Practice Address - Fax:202-223-1738
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer