Healthcare Provider Details

I. General information

NPI: 1629353396
Provider Name (Legal Business Name): CHRIS ESTAFANOUS D.P.T
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2011
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 13TH STREET NW C112
WASHINGTON DC DC
20004
US

IV. Provider business mailing address

555 13TH ST NW STE C112
WASHINGTON DC
20004-1141
US

V. Phone/Fax

Practice location:
  • Phone: 202-347-1800
  • Fax: 202-521-3499
Mailing address:
  • Phone: 917-734-1080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT871467
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: