Healthcare Provider Details

I. General information

NPI: 1902727985
Provider Name (Legal Business Name): FATMA ESRA SOYDAN L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13777 AIR AND SPACE MUSEUM PKWY
HERNDON VA
20171-4189
US

IV. Provider business mailing address

13777 AIR AND SPACE MUSEUM PKWY
HERNDON VA
20171-4189
US

V. Phone/Fax

Practice location:
  • Phone: 434-327-0072
  • Fax:
Mailing address:
  • Phone: 434-327-0072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number0121001286
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: