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General NPI Number Information
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NPI Number | 1073570800
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Entity Type | Individual
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Provider Name | ANDREW PAUL CICHOSZ PT
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Gender | Male
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 11/29/2010
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Provider Practice Location Address
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Address Line | 402 W BROAD ST 2ND FLOOR
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City | FALLS CHURCH
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State | VA
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Zip | 22046-3337
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Country | US
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Telephone | 240-463-4665
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Fax |
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Provider Business Mailing Address
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Address Line | 2826 YARLING COURT
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City | FALLS CHURCH
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State | VA
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Zip | 22042-4465
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Country | US
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Telephone | 240-463-4665
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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 | 870572
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305005347
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License Number State | VA
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