Healthcare Provider Details
I. General information
NPI: 1912820671
Provider Name (Legal Business Name): NOVA ANESTHESIA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11351 RANDON HILLS RD UNIT 350
FAIRFAX VA
22030
US
IV. Provider business mailing address
11351 RANDON HILLS RD UNIT 350
FAIRFAX VA
22030
US
V. Phone/Fax
- Phone: 703-378-1734
- Fax: 703-378-1735
- Phone: 703-378-1734
- Fax: 703-378-1735
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NISHA
CHAND
Title or Position: OWNER
Credential: MD
Phone: 703-728-7736