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General NPI Number Information
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NPI Number | 1295189835
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Entity Type | Organization
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Legal Business Name | NEUROLOFT II LLC
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Dates
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Enumeration Date | 04/20/2016
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 11107 SUNSET HILLS RD STE 110
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City | RESTON
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State | VA
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Zip | 20190-5376
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Country | US
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Telephone | 703-689-0003
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Fax | 703-775-4944
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Provider Business Mailing Address
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Address Line | 11107 SUNSET HILLS RD STE 110
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City | RESTON
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State | VA
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Zip | 20190-5376
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Country | US
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Telephone | 703-689-0003
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Fax | 703-775-4944
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. MAUREEN M LOFTUS
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Credential |
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Telephone | 703-689-0003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number | 0810003327
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License Number State | VA
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