Hadi Fathalikhani, PT
Individual provider Active NPI Physical Therapist · Woodbridge, VA
NPI 1962407411 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1962407411
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 2305003984 (VA)
- Practice address
- 12546 Dillingham SQ
# 101
Woodbridge, VA 22192-5259 - Phone
- (703) 730-6969
- Fax
- (703) 730-1169
- NPI assigned
- Jun 20, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Ridge Physical Therapy, LLC | Physical Therapist | Current |
Accepting new patients |
Locations
3767 Fettler Park Dr
Dumfries, VA 22025
Phone (703) 730-6400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305003984 | VA | Yes |
Addresses
Primary practice location
12546 Dillingham SQ
# 101
Woodbridge, VA 22192-5259
Mailing address
14014 Sullyfield Cir
Ste B
Chantilly, VA 20151-1689
Phone (703) 263-2020
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 519289 | Other | VA | MAMSI PROVIDER NUMBER |
| S427-0001 | Other | VA | CAREFIRST BCBS PROVIDER # |
| 265661 | Other | VA | ANTHEM PROVIDER NUMBER |
Other providers in Woodbridge, VA
- Maidah Farooq
- Muazzam Farooq
- Atoussa Farough
- Zohreh Farzad
- Kaniz Fatema
- Fatherandsoncom
- Andre F Feltren
- Yordanos Fente
- Breanna Ferguson
- Stephen Lawrence Ferlazzo
All providers in Woodbridge, VA · Physical Therapist in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.