Healthcare Provider Details

I. General information

NPI: 1740100213
Provider Name (Legal Business Name): ANISA CHOWDHURY LRC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10710 MIDLOTHIAN TPKE STE 127
NORTH CHESTERFIELD VA
23235-4776
US

IV. Provider business mailing address

10710 MIDLOTHIAN TPKE STE 127
NORTH CHESTERFIELD VA
23235-4776
US

V. Phone/Fax

Practice location:
  • Phone: 804-220-0903
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number0704019392
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: