Sutphin, Elena Igorevna

Sutphin, Elena Igorevna is an individual health care provider with primary practice located at 1936 Opitz Blvd Ste A , Woodbridge VA 22191-3360. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Rehabilitation Medicine, Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is her primary health care specialty. Sutphin, Elena Igorevna can be contacted via phone (540) 841-4443.

Contact Information

Primary practice address
1936 Opitz Blvd Ste A Woodbridge VA 22191-3360
Phone: (540) 841-4443
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Rehabilitation Medicine 2081P0010X 2306605532 Virginia
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 2306605532 Virginia

Profile Details

NPI number 1134727357
LBN Legal business name Sutphin, Elena Igorevna
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 9th, 2020
Last updated Oct 9th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134727357 NPPES
Virginia Other 2306605532 VA DEPARTMENT OF HEALTH PROFESSIONALS/BOARD OF PHYSICAL THERAPY

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