Basic Information
| Provider Information | |||||||||
| NPI: | 1558389528 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRIEDMAN | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | G | ||||||||
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| Credential: | DPT | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | GELDMACHER | ||||||||
| OtherFirstName: | BETH | ||||||||
| OtherMiddleName: | M | ||||||||
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| OtherCredential: | DPT | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 11240 WAPLES MILL ROAD | ||||||||
| Address2: | SUITE 403 | ||||||||
| City: | FAIRFAX | ||||||||
| State: | VA | ||||||||
| PostalCode: | 22030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7033854707 | ||||||||
| FaxNumber: | 7036914933 | ||||||||
| Practice Location | |||||||||
| Address1: | 8501 ARLINGTON BLVD | ||||||||
| Address2: | STE 400 | ||||||||
| City: | FAIRFAX | ||||||||
| State: | VA | ||||||||
| PostalCode: | 22031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7035733843 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2006 | ||||||||
| LastUpdateDate: | 07/02/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 2305203985 | VA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.