Provider Demographics
NPI:1780898023
Name:HELETSI, ANDRE B (DPT)
Entity type:Individual
Prefix:
First Name:ANDRE
Middle Name:B
Last Name:HELETSI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:4649 BATTENBURG LN
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-6269
Mailing Address - Country:US
Mailing Address - Phone:703-989-3449
Mailing Address - Fax:703-865-7918
Practice Address - Street 1:44933 GEORGE WASHINGTON BLVD
Practice Address - Street 2:SUITE 165
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-6300
Practice Address - Country:US
Practice Address - Phone:703-989-3449
Practice Address - Fax:703-865-7918
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA23052049892251X0800X
225000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter