MEDICARE: DR. LINA IBRAHIM PT, DPT, LAT, ATC

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	2305217425	VA

General Provider Information

NPI Number	:	1447193321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINA IBRAHIM PT, DPT, LAT, ATC

Provider Business Mailing Address
First Line	:	8018 GRANDVIEW CT
Second Line	:
City	:	SPRINGFIELD
State	:	VA
Zip	:	22153-3813
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1228 BLAGDEN ALY NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20001-4434
Country	:	US
Telephone Number	:	202-705-9330
Fax Number	:

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

Provider Enumeration Date	:	04/14/2026
Last Update Date	:	04/14/2026

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