Healthcare Provider Details

I. General information

NPI: 1740078609
Provider Name (Legal Business Name): NEELANSHI SAXENA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2025
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9455 LORTON MARKET ST
LORTON VA
22079-1962
US

IV. Provider business mailing address

6601 ROCK LAWN DR
CLIFTON VA
20124-2527
US

V. Phone/Fax

Practice location:
  • Phone: 703-647-3120
  • Fax:
Mailing address:
  • Phone: 571-428-9506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: