Healthcare Provider Details

I. General information

NPI: 1326963752
Provider Name (Legal Business Name): NOVER SAMY AMIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5211 W BROAD ST STE 101
RICHMOND VA
23230-3000
US

IV. Provider business mailing address

5211 W BROAD ST STE 101
RICHMOND VA
23230-3000
US

V. Phone/Fax

Practice location:
  • Phone: 804-288-3025
  • Fax:
Mailing address:
  • Phone: 804-288-3025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305217958
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: