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NPI Code Detail

MEDICARE: MR. GEOFFREY NAI-TETTEH PTA

MEDICARE: MR. GEOFFREY NAI-TETTEH PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant2306001080VA

General Provider Information

NPI Number : 1811016462
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GEOFFREY NAI-TETTEH PTA
Provider Business Mailing Address
First Line : 5604 BLOOMFIELD DR
Second Line : APT. 203
City : ALEXANDRIA
State : VA
Zip : 22312-2560
Country : US
Telephone Number : 703-920-5700
Fax Number :
Provider Business Practice Location Address
First Line : 1785 S HAYES ST
Second Line :
City : ARLINGTON
State : VA
Zip : 22202-2714
Country : US
Telephone Number : 703-920-5700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2007
Last Update Date : 07/08/2007

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