Provider Demographics
NPI:1801934559
Name:POSA, NICOLAS PABLO (PT, DPT)
Entity type:Individual
Prefix:MR
First Name:NICOLAS
Middle Name:PABLO
Last Name:POSA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43293 RAILSTOP TER
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-5329
Mailing Address - Country:US
Mailing Address - Phone:703-421-3905
Mailing Address - Fax:
Practice Address - Street 1:20905 PROFESSIONAL PLZ STE 110
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-3409
Practice Address - Country:US
Practice Address - Phone:703-726-0003
Practice Address - Fax:703-726-6444
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33462225100000X
VA2305205854225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist