Amna Abugusseisa

Individual provider Active NPI Driver · Lorton, VA

NPI 1821597576 · NPPES record last updated Feb 8, 2018

Key facts

NPI
1821597576
Entity type
Individual (NPI type 1)
Primary specialty
Driver 172A00000X
Practice address
8159 Gilroy Dr
Lorton, VA 22079-2939
Phone
(202) 437-3331
NPI assigned
Feb 8, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Driver
Group: 193400000X SINGLE SPECIALTY GROUP
172A00000X Yes

Addresses

Primary practice location

8159 Gilroy Dr
Lorton, VA 22079-2939

Mailing address

8159 Gilroy Dr
Lorton, VA 22079-2939

Other identifiers

IdentifierTypeStateIssuer
697OtherCERTIFICATE OF AUTHORITY

Other providers in Lorton, VA

All providers in Lorton, VA · Driver in Virginia

Sources for this page

Verify at the official NPI Registry.