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NPI Code Detail

MEDICARE: NIJAH M CHINN PT, MHA

MEDICARE: NIJAH M CHINN PT, MHA
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
1225100000XPhysical Therapist2305005030VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00726345OTHERVARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1192946OTHERVABCBS (PHYSICAL THERAPY)
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
44651942OTHERVAAETNA

General Provider Information

NPI Number : 1386872968
Entity Type Code : Individual
Provider Name (Legal Business Name) : NIJAH M CHINN PT, MHA
Provider Business Mailing Address
First Line : 771 PILOT HOUSE DR
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23606-1990
Country : US
Telephone Number : 757-873-2302
Fax Number : 757-873-2306
Provider Business Practice Location Address
First Line : 300B TEMPLE LAKE DR
Second Line : SUITE 1
City : COLONIAL HEIGHTS
State : VA
Zip : 23834-2973
Country : US
Telephone Number : 804-524-9036
Fax Number : 804-524-9039
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2009
Last Update Date : 08/20/2009

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Directions to “ NIJAH M CHINN PT, MHA” Practice Location

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