=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083504310
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | UNITY FAMILY HEALTH CENTER PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/08/2025
-----------------------------------------------------
Last Update Date | 12/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 850 WALNUT BOTTOM RD STE 101B
-----------------------------------------------------
City | CARLISLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17013-3615
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-702-1642
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4504 GASTON ST
-----------------------------------------------------
City | CHANTILLY
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 20151-2244
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINSTRATOR
-----------------------------------------------------
Name | ASHISH SANGROULA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 202-702-1642
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------