Provider Demographics
NPI:1346781192
Name:ASPA, MARIA ANTONETTE (PT)
Entity type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:ANTONETTE
Last Name:ASPA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:ANTONETTE
Other - Last Name:ASPA-CORTEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:11350 RANDOM HILLS RD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-6044
Mailing Address - Country:US
Mailing Address - Phone:646-338-8955
Mailing Address - Fax:703-563-9468
Practice Address - Street 1:11350 RANDOM HILLS RD
Practice Address - Street 2:SUITE 800
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-6044
Practice Address - Country:US
Practice Address - Phone:646-338-8955
Practice Address - Fax:703-563-9468
Is Sole Proprietor?:No
Enumeration Date:2017-03-13
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23052055912251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic