Healthcare Provider Details

I. General information

NPI: 1407483472
Provider Name (Legal Business Name): BHASHA MUKHOPADHYAY SATYASI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8503 ARLINGTON BLVD STE 400
FAIRFAX VA
22031-4629
US

IV. Provider business mailing address

PO BOX 37189
BALTIMORE MD
21297-3189
US

V. Phone/Fax

Practice location:
  • Phone: 703-207-8600
  • Fax: 703-207-9224
Mailing address:
  • Phone: 571-423-5699
  • Fax: 571-423-5698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0102208024
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: