Healthcare Provider Details

I. General information

NPI: 1508862095
Provider Name (Legal Business Name): ARLENE HERNANDEZ P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 12/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 UNIVERSITY BLVD E STE 34
SILVER SPRING MD
20903-2915
US

IV. Provider business mailing address

2306 PIONEER CT
FORT WASHINGTON MD
20744-2670
US

V. Phone/Fax

Practice location:
  • Phone: 301-839-1600
  • Fax: 301-567-1207
Mailing address:
  • Phone: 301-839-1600
  • Fax: 301-567-1207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number15880
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: