Provider Demographics
NPI:1639940844
Name:NAVIWALA, FARHEEN
Entity Type:Individual
Prefix:
First Name:FARHEEN
Middle Name:
Last Name:NAVIWALA
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 1:109 HAVERFORD CT
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22602-6873
Mailing Address - Country:US
Mailing Address - Phone:617-571-6955
Mailing Address - Fax:
Practice Address - Street 1:519 W JUBAL EARLY DR STE 102
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6519
Practice Address - Country:US
Practice Address - Phone:540-665-0104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306606444225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant