Provider Demographics
NPI:1255771515
Name:ESPANDYARI, HAMID (PT)
Entity type:Individual
Prefix:MR
First Name:HAMID
Middle Name:
Last Name:ESPANDYARI
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 1:8316 ARLINGTON BLVD #520
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX,
Mailing Address - State:VA
Mailing Address - Zip Code:22031
Mailing Address - Country:US
Mailing Address - Phone:703-205-1999
Mailing Address - Fax:703-205-1911
Practice Address - Street 1:8316 ARLINGTON BLVD #520
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031
Practice Address - Country:US
Practice Address - Phone:703-205-1999
Practice Address - Fax:703-205-1911
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-01
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305004058261QP2000X
VA230500408225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty