Healthcare Provider Details

I. General information

NPI: 1760119119
Provider Name (Legal Business Name): ANDREW G DEL CARMINE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2022
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6410 ROCKLEDGE DR STE 600
BETHESDA MD
20817-1844
US

IV. Provider business mailing address

6410 ROCKLEDGE DR STE 600
BETHESDA MD
20817-1844
US

V. Phone/Fax

Practice location:
  • Phone: 301-581-8030
  • Fax: 301-581-8031
Mailing address:
  • Phone: 301-581-8030
  • Fax: 301-581-8031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number30968
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number13648
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0020858
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: