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General NPI Number Information
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NPI Number | 1952693673
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Entity Type | Individual
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Provider Name | FNU SOUMYA SEBASTIAN PT
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Gender | Female
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Dates
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Enumeration Date | 05/13/2011
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Last Update Date | 05/13/2011
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Provider Practice Location Address
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Address Line | 700 CONSTITUTION AVE NE REHAB DEPT
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City | WASHINGTON
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State | DC
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Zip | 20002-6058
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Country | US
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Telephone | 202-543-4800
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Fax | 202-629-5467
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Provider Business Mailing Address
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Address Line | 7689 PALMILLA DR APT # 1304
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City | SAN DIEGO
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State | CA
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Zip | 92122-4712
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Country | US
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Telephone |
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Fax |
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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 | PT871130
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License Number State | DC
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