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General NPI Number Information
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NPI Number | 1912223306
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Entity Type | Individual
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Provider Name | SONAL JAGASIA MD
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Gender | Female
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Dates
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Enumeration Date | 04/11/2010
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 2220 CEDAR LN STE 100
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City | VIENNA
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State | VA
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Zip | 22182-5251
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Country | US
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Telephone | 571-368-6654
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Fax | 571-368-6656
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Provider Business Mailing Address
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Address Line | 2220 CEDAR LN STE 100
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City | VIENNA
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State | VA
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Zip | 22182-5251
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Country | US
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Telephone | 571-368-6654
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Fax | 571-368-6656
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD042640
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101256643
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License Number State | VA
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