Healthcare Provider Details

I. General information

NPI: 1609174424
Provider Name (Legal Business Name): CHING-I HSU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2011
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14428 ALBEMARLE POINT PL STE 150B
CHANTILLY VA
20151-1752
US

IV. Provider business mailing address

1855 MICHAEL FARADAY DR
RESTON VA
20190-5346
US

V. Phone/Fax

Practice location:
  • Phone: 703-712-7622
  • Fax:
Mailing address:
  • Phone: 646-479-9026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT010001641
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number016061
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number0119008333
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: