Basic Information
| Provider Information | |||||||||
| NPI: | 1730416876 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AHUJA | ||||||||
| FirstName: | VISHAKHA | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | O.T | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7501 HERITAGE VILLAGE PLZ | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201553078 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5712486100 | ||||||||
| FaxNumber: | 5712486455 | ||||||||
| Practice Location | |||||||||
| Address1: | 7501 HERITAGE VILLAGE PLZ | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201553078 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5712486100 | ||||||||
| FaxNumber: | 5712486455 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/11/2009 | ||||||||
| LastUpdateDate: | 11/11/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 0119003523 | VA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.