Provider Demographics
NPI:1043327695
Name:UNNI, MONICA GUPTA (PA)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:GUPTA
Last Name:UNNI
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:44045 RIVERSIDE PKWY
Mailing Address - Street 2:LOUDOUN HOSPITAL CENTER
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-5101
Mailing Address - Country:US
Mailing Address - Phone:703-858-6044
Mailing Address - Fax:703-858-6775
Practice Address - Street 1:44045 RIVERSIDE PKWY
Practice Address - Street 2:LOUDOUN HOSPITAL CENTER
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-5101
Practice Address - Country:US
Practice Address - Phone:703-858-6044
Practice Address - Fax:703-858-6775
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01100020278363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA011128C77Medicare PIN