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General NPI Number Information
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NPI Number | 1346829413
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Entity Type | Individual
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Provider Name | SHREYA MATHUR
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Gender | Female
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Dates
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Enumeration Date | 04/06/2021
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 21035 SYCOLIN ROAD, SUITE 180
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City | ASHBURN
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State | VA
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Zip | 20147-4311
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Country | US
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Telephone | 703-783-5673
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Fax | 703-297-3919
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Provider Business Mailing Address
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Address Line | 224-D CORNWALL STREET, NW, STE 403
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City | LEESBURG
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State | VA
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Zip | 20176-2704
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Country | US
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Telephone | 703-737-6010
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Fax | 703-443-8610
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 209022903
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 0024188865
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License Number State | VA
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