Healthcare Provider Details

I. General information

NPI: 1972667657
Provider Name (Legal Business Name): NIRAJA SINGH SHRESTHA DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NIRAJA KARMACHARYA

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 07/13/2022
Certification Date: 07/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8100 BRADDOCK RD
ANNANDALE VA
22003-4632
US

IV. Provider business mailing address

12555 CERROMAR PL
FAIRFAX VA
22030-6654
US

V. Phone/Fax

Practice location:
  • Phone: 571-472-0141
  • Fax: 703-323-3668
Mailing address:
  • Phone: 703-583-4163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305203429
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: