Healthcare Provider Details

I. General information

NPI: 1609712959
Provider Name (Legal Business Name): SWATHI RAGIPHANI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2515 FARMCREST DR APT 104
HERNDON VA
20171-3161
US

IV. Provider business mailing address

2515 FARMCREST DR APT 104
HERNDON VA
20171-3161
US

V. Phone/Fax

Practice location:
  • Phone: 469-531-4644
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA000173
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: