Healthcare Provider Details

I. General information

NPI: 1720976251
Provider Name (Legal Business Name): GENISCI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2025
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 CATOCTIN CIR NE STE 101-102
LEESBURG VA
20176-3102
US

IV. Provider business mailing address

24850 HOGUE CREEK CT
ALDIE VA
20105-5974
US

V. Phone/Fax

Practice location:
  • Phone: 571-556-2893
  • Fax:
Mailing address:
  • Phone: 920-562-4465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code310500000X
TaxonomyMental Illness Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. REZAUL ABID
Title or Position: CEO AND PRESIDENT
Credential: PHD, MENG, FELLOW
Phone: 571-556-2892