Healthcare Provider Details

I. General information

NPI: 1699473470
Provider Name (Legal Business Name): SNEHAL SATYAJIT BHAGWAT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2023
Last Update Date: 11/07/2024
Certification Date: 11/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5411 W CEDAR LN STE 105A
BETHESDA MD
20814-1516
US

IV. Provider business mailing address

5411 W CEDAR LN
BETHESDA MD
20814-1516
US

V. Phone/Fax

Practice location:
  • Phone: 301-564-4040
  • Fax: 301-564-3604
Mailing address:
  • Phone: 571-665-9740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number29302
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: