Provider Demographics
NPI:1992462113
Name:PARNE, MANJULA DEVI (RRT)
Entity type:Individual
Prefix:
First Name:MANJULA
Middle Name:DEVI
Last Name:PARNE
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:25501 EMERSON OAKS DR
Mailing Address - Street 2:
Mailing Address - City:ALDIE
Mailing Address - State:VA
Mailing Address - Zip Code:20105-3125
Mailing Address - Country:US
Mailing Address - Phone:571-217-0010
Mailing Address - Fax:
Practice Address - Street 1:8301 ARLINGTON BLVD STE 209
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2902
Practice Address - Country:US
Practice Address - Phone:571-217-0010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-22
Last Update Date:2023-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01170058672278P1006X, 225B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2278P1006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedPulmonary Function Technologist
No225B00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPulmonary Function TechnologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1992462113Medicaid