MEDICARE: FARIBA DJANGALI PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	17523	MD

General Provider Information

NPI Number	:	1689832180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FARIBA DJANGALI PT

Provider Business Mailing Address
First Line	:	155 SALLITT DR
Second Line	:
City	:	STEVENSVILLE
State	:	MD
Zip	:	21666-2156
Country	:	US
Telephone Number	:	410-643-3130
Fax Number	:	410-643-3083

Provider Business Practice Location Address
First Line	:	155 SALLITT DR
Second Line	:
City	:	STEVENSVILLE
State	:	MD
Zip	:	21666-2156
Country	:	US
Telephone Number	:	410-643-3130
Fax Number	:	410-643-3083

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2008
Last Update Date	:	05/30/2008

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Directions to “ FARIBA DJANGALI PT” Practice Location

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