Provider Demographics
NPI:1588826978
Name:HAND REHABILITATION OF VIRGINIA LLC
Entity Type:Organization
Organization Name:HAND REHABILITATION OF VIRGINIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:FITZGERALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-873-8839
Mailing Address - Street 1:11848 ROCK LANDING DR
Mailing Address - Street 2:SUITE 303
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4425
Mailing Address - Country:US
Mailing Address - Phone:757-873-8839
Mailing Address - Fax:757-873-1142
Practice Address - Street 1:11848 ROCK LANDING DR
Practice Address - Street 2:SUITE 303
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4425
Practice Address - Country:US
Practice Address - Phone:757-873-8839
Practice Address - Fax:757-873-1142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-27
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119002324174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAGC1010Medicare PIN