Provider Demographics
NPI:1679845416
Name:NAGDA, ALISHA (PT)
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:
Last Name:NAGDA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ALISHA
Other - Middle Name:
Other - Last Name:SHAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1769
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20118-1769
Mailing Address - Country:US
Mailing Address - Phone:540-687-8181
Mailing Address - Fax:540-687-8256
Practice Address - Street 1:6551 LOISDALE CT
Practice Address - Street 2:SUITE 155
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-1828
Practice Address - Country:US
Practice Address - Phone:703-822-0039
Practice Address - Fax:703-822-0211
Is Sole Proprietor?:No
Enumeration Date:2012-02-08
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305207235225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist