Healthcare Provider Details

I. General information

NPI: 1982129078
Provider Name (Legal Business Name): RANJANA KANUNGO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2017
Last Update Date: 10/25/2022
Certification Date: 10/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 NEW MEXICO AVE NW STE 250
WASHINGTON DC
20016-3610
US

IV. Provider business mailing address

PO BOX 69020
BALTIMORE MD
21264-9020
US

V. Phone/Fax

Practice location:
  • Phone: 202-517-7388
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2305213444
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT872107
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: