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General NPI Number Information
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NPI Number | 1972279990
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Entity Type | Individual
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Provider Name | ERICA NIKOLAIDIS PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 08/19/2021
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 2987 DISTRICT AVE STE 140
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City | FAIRFAX
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State | VA
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Zip | 22031-1571
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Country | US
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Telephone | 703-890-0433
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Fax |
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Provider Business Mailing Address
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Address Line | 8340 GREENSBORO DR UNIT 1006
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City | MC LEAN
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State | VA
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Zip | 22102-3546
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Country | US
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Telephone | 703-896-9999
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 2305214603
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License Number State | VA
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