Healthcare Provider Details

I. General information

NPI: 1346169570
Provider Name (Legal Business Name): NAFISA ADIL ABDALMAGED HAMADTO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25192 LARKS TER
CHANTILLY VA
20152-6680
US

IV. Provider business mailing address

2344 CYPRESS COVE CIR UNIT C
HERNDON VA
20171-3584
US

V. Phone/Fax

Practice location:
  • Phone: 571-419-3279
  • Fax:
Mailing address:
  • Phone: 571-419-3279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: