Provider Demographics
NPI:1609909761
Name:ARMECIN, NADJA ELAINE
Entity Type:Individual
Prefix:
First Name:NADJA
Middle Name:ELAINE
Last Name:ARMECIN
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 1:3615 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-1961
Mailing Address - Country:US
Mailing Address - Phone:540-380-2986
Mailing Address - Fax:
Practice Address - Street 1:3615 W. MAIN STREET
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-1961
Practice Address - Country:US
Practice Address - Phone:540-380-2986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22020225100000X
VA2305206857225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist