Healthcare Provider Details

I. General information

NPI: 1336073337
Provider Name (Legal Business Name): AWANI RATNAKAR GAWASKAR PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9211 STUART LN
CLINTON MD
20735-2712
US

IV. Provider business mailing address

4451 TELFAIR BLVD APT 4103
CAMP SPRINGS MD
20746-5262
US

V. Phone/Fax

Practice location:
  • Phone: 301-868-3600
  • Fax:
Mailing address:
  • Phone: 919-920-1438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number26880
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: