Healthcare Provider Details

I. General information

NPI: 1083427108
Provider Name (Legal Business Name): NESREEN ALMOSADDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2025
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 OMNI BLVD
NEWPORT NEWS VA
23606-4434
US

IV. Provider business mailing address

860 OMNI BLVD
NEWPORT NEWS VA
23606-4434
US

V. Phone/Fax

Practice location:
  • Phone: 757-369-8138
  • Fax:
Mailing address:
  • Phone: 757-369-8138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: