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NPI 1134600224

NPI 1134600224 : LEENA NATHAN DPT : HERNDON, VA

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General NPI Number Information
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    NPI Number           |    1134600224
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    Entity Type          |    Individual 
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    Provider Name        |    LEENA NATHAN DPT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/27/2018
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    Last Update Date     |    02/03/2025
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Provider Practice Location Address
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    Address Line         |    13019 WORLDGATE DR 
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    City                 |    HERNDON
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    State                |    VA
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    Zip                  |    20170-4374
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    Country              |    US
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    Telephone            |    703-870-2450
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    Fax                  |    703-870-2451
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Provider Business Mailing Address
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    Address Line         |    2122 YORK RD STE 300 
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    City                 |    OAK BROOK
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    State                |    IL
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    Zip                  |    60523-1925
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    Country              |    US
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    Telephone            |    630-575-6200
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    Fax                  |    410-648-4878
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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       |    26702
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    License Number State |    MD
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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       |    2305216776
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    License Number State |    VA
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