Provider Demographics
NPI:1598165961
Name:NARRA, SAI SHANTHI
Entity type:Individual
Prefix:
First Name:SAI SHANTHI
Middle Name:
Last Name:NARRA
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 1:43464 KATLING SQ
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20152-2517
Mailing Address - Country:US
Mailing Address - Phone:804-551-0414
Mailing Address - Fax:
Practice Address - Street 1:43464 KATLING SQ
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20152-2517
Practice Address - Country:US
Practice Address - Phone:804-551-0414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-03
Last Update Date:2024-06-16
Deactivation Date:2018-04-19
Deactivation Code:
Reactivation Date:2018-05-16
Provider Licenses
StateLicense IDTaxonomies
MD23518225100000X
NY036839225100000X
SD1779225100000X
VA2305210549225100000X
NY009014225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant