Healthcare Provider Details

I. General information

NPI: 1023938230
Provider Name (Legal Business Name): NOVA ENDOSCOPY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11351 RANDOM HILLS RD UNIT 350
FAIRFAX VA
22030-6081
US

IV. Provider business mailing address

11351 RANDOM HILLS RD UNIT 350
FAIRFAX VA
22030-6081
US

V. Phone/Fax

Practice location:
  • Phone: 703-378-1734
  • Fax: 703-378-1735
Mailing address:
  • Phone: 703-378-1734
  • Fax: 703-378-1735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NISHA CHAND
Title or Position: OWNER
Credential:
Phone: 703-728-7736