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General NPI Number Information
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NPI Number | 1295495331
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE HYPERBARIC NOVA LLC
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Dates
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Enumeration Date | 12/29/2021
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 19465 DEERFIELD AVE STE 308
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City | LEESBURG
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State | VA
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Zip | 20176-1701
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Country | US
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Telephone | 703-938-1421
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Fax | 703-938-1424
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Provider Business Mailing Address
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Address Line | 19465 DEERFIELD AVE STE 308
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City | LEESBURG
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State | VA
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Zip | 20176-1701
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Country | US
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Telephone | 571-595-2610
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Fax | 703-938-1424
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Authorized Official
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Title or Position | C.O.O.
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Name | NATHANIEL DAVID GOREN
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Credential |
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Telephone | 703-938-1421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2083P0011X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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