Provider Demographics
NPI:1972759181
Name:ABDELGHANY, USAMA M (PT)
Entity Type:Individual
Prefix:MR
First Name:USAMA
Middle Name:M
Last Name:ABDELGHANY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6408 GROVEDALE DR STE 203
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-2596
Mailing Address - Country:US
Mailing Address - Phone:703-313-0044
Mailing Address - Fax:703-313-0081
Practice Address - Street 1:6408 GROVEDALE DR STE 203
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-2596
Practice Address - Country:US
Practice Address - Phone:703-313-0044
Practice Address - Fax:703-313-0081
Is Sole Proprietor?:No
Enumeration Date:2008-08-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305005855225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist