Healthcare Provider Details

I. General information

NPI: 1346865151
Provider Name (Legal Business Name): PRIYANKA CHATI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2020
Last Update Date: 06/08/2020
Certification Date: 06/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 GALLOWS RD
FALLS CHURCH VA
22042-3307
US

IV. Provider business mailing address

2726 GALLOWS RD APT 604
VIENNA VA
22180-7145
US

V. Phone/Fax

Practice location:
  • Phone: 540-556-1201
  • Fax:
Mailing address:
  • Phone: 540-556-1201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0116033754
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: