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General NPI Number Information
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NPI Number | 1063256410
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Entity Type | Individual
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Provider Name | MINA SEYED-ALI PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 06/20/2024
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 4980 WYACONDA RD STE A-B
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City | NORTH BETHESDA
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State | MD
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Zip | 20852-2468
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Country | US
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Telephone | 301-298-9868
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Fax |
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Provider Business Mailing Address
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Address Line | 5225 POOKS HILL RD APT 116N
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City | BETHESDA
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State | MD
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Zip | 20814-6737
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Country | US
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Telephone | 240-565-9152
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 30226
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License Number State | MD
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