Provider Demographics
NPI:1023735206
Name:TAILOR, SAPANA JAYANTILAL
Entity type:Individual
Prefix:
First Name:SAPANA
Middle Name:JAYANTILAL
Last Name:TAILOR
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 1:25348 MCINTYRE SQ
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20152-3971
Mailing Address - Country:US
Mailing Address - Phone:571-598-9333
Mailing Address - Fax:
Practice Address - Street 1:20 PIDGEON HILL DR STE 103
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-6134
Practice Address - Country:US
Practice Address - Phone:571-313-0929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-27
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305214519225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist