Healthcare Provider Details

I. General information

NPI: 1144962986
Provider Name (Legal Business Name): CYNTHIA KAFUI GANA DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2022
Last Update Date: 04/12/2022
Certification Date: 04/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 MACARTHUR BLVD NW
WASHINGTON DC
20016-2541
US

IV. Provider business mailing address

6024 OAKLAWN LN
WOODBRIDGE VA
22193-3962
US

V. Phone/Fax

Practice location:
  • Phone: 202-349-3400
  • Fax:
Mailing address:
  • Phone: 571-296-8305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT5000021
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: