Healthcare Provider Details

I. General information

NPI: 1821259565
Provider Name (Legal Business Name): ALIYAT YIMAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 PIDGEON HILL DR STE 103
STERLING VA
20165-6134
US

IV. Provider business mailing address

7710 CUMBERTREE CT
SPRINGFIELD VA
22153-2165
US

V. Phone/Fax

Practice location:
  • Phone: 202-870-4996
  • Fax:
Mailing address:
  • Phone: 202-870-4996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305205266
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: