Healthcare Provider Details

I. General information

NPI: 1770677643
Provider Name (Legal Business Name): SUBHA NAGASUBRAMANIAN PHYSICAL THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 H ST NW STE 1100
WASHINGTON DC
20005-5967
US

IV. Provider business mailing address

1100 H ST NW STE 1100
WASHINGTON DC
20005-5967
US

V. Phone/Fax

Practice location:
  • Phone: 202-794-6821
  • Fax:
Mailing address:
  • Phone: 202-794-6821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number871202
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: