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NPI Code Detail

MEDICARE: JOSHUA ALEXANDER PRIBADI

MEDICARE: JOSHUA ALEXANDER PRIBADI
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1508704107
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSHUA ALEXANDER PRIBADI
Provider Business Mailing Address
First Line : 13289 SCOTCH RUN CT
Second Line :
City : CENTREVILLE
State : VA
Zip : 20120-6450
Country : US
Telephone Number : 703-678-1538
Fax Number :
Provider Business Practice Location Address
First Line : 3800 RESERVOIR RD NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20007-2113
Country : US
Telephone Number : 202-444-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2026
Last Update Date : 03/24/2026

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Directions to “ JOSHUA ALEXANDER PRIBADI ” Practice Location

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