MEDICARE: BHUMI ANISH DESAI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2305206055	VA

General Provider Information

NPI Number	:	1003078833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BHUMI ANISH DESAI

Provider Business Mailing Address
First Line	:	24917 PINEBROOK RD
Second Line	:
City	:	CHANTILLY
State	:	VA
Zip	:	20152-4397
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	24801 PINEBROOK RD STE 200
Second Line	:
City	:	CHANTILLY
State	:	VA
Zip	:	20152-4113
Country	:	US
Telephone Number	:	703-722-2525
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2008
Last Update Date	:	07/29/2020

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Directions to “ BHUMI ANISH DESAI ” Practice Location

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