Healthcare Provider Details

I. General information

NPI: 1013987080
Provider Name (Legal Business Name): MARY SADAYA-GUILLERMO P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 07/13/2026
Certification Date: 08/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10215 FERNWOOD RD #506
BETHESDA MD
20817-1106
US

IV. Provider business mailing address

10215 FERNWOOD RD #506
BETHESDA MD
20817-1106
US

V. Phone/Fax

Practice location:
  • Phone: 301-530-1010
  • Fax:
Mailing address:
  • Phone: 301-530-1010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number16953
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305213512
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: