Healthcare Provider Details

I. General information

NPI: 1184189748
Provider Name (Legal Business Name): AKSHAY NITISH HUDLIKAR MPT, DPT, GCS, CLT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2019
Last Update Date: 02/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 NORTH PL
FREDERICK MD
21701-6200
US

IV. Provider business mailing address

4 CAPPS CT
GAITHERSBURG MD
20878-1953
US

V. Phone/Fax

Practice location:
  • Phone: 301-695-6618
  • Fax:
Mailing address:
  • Phone: 909-289-8144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: