Provider Demographics
NPI:1538952569
Name:AHMAD, ROYA
Entity type:Individual
Prefix:
First Name:ROYA
Middle Name:
Last Name:AHMAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5644 IVY HILL DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBRG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-9207
Mailing Address - Country:US
Mailing Address - Phone:540-710-4746
Mailing Address - Fax:
Practice Address - Street 1:5644 IVY HILL DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBRG
Practice Address - State:VA
Practice Address - Zip Code:22407-9207
Practice Address - Country:US
Practice Address - Phone:540-710-4746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306606710225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant