Provider Demographics
NPI:1629734207
Name:RIZKALLA, MONICA NABIL
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:NABIL
Last Name:RIZKALLA
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 1:17706 CRICKET HILL DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-3458
Mailing Address - Country:US
Mailing Address - Phone:301-717-2752
Mailing Address - Fax:
Practice Address - Street 1:950 HERNDON PKWY STE 130
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-5526
Practice Address - Country:US
Practice Address - Phone:703-904-9666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104-557772111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor