Provider Demographics
NPI:1992740377
Name:KALE, ADITI (MPT)
Entity type:Individual
Prefix:MS
First Name:ADITI
Middle Name:
Last Name:KALE
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4122 GROVER GLEN CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-6021
Mailing Address - Country:US
Mailing Address - Phone:703-273-0665
Mailing Address - Fax:
Practice Address - Street 1:11230 WAPLES MILL RD
Practice Address - Street 2:SUITE 130
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-6087
Practice Address - Country:US
Practice Address - Phone:703-273-2400
Practice Address - Fax:703-691-1486
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2018-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305203123225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist