Provider Demographics
NPI:1053559534
Name:KALRA, NITIN (PT)
Entity type:Individual
Prefix:
First Name:NITIN
Middle Name:
Last Name:KALRA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41756 CORDGRASS CIR
Mailing Address - Street 2:
Mailing Address - City:ALDIE
Mailing Address - State:VA
Mailing Address - Zip Code:20105-5604
Mailing Address - Country:US
Mailing Address - Phone:571-275-3470
Mailing Address - Fax:
Practice Address - Street 1:14366 BROADWINGED DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-5929
Practice Address - Country:US
Practice Address - Phone:571-275-3470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-22
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305205268225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist