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NPI Code Detail

MEDICARE: DR. ADERONKE M M ABASSI PHYSICAL THERAPIST

MEDICARE: DR. ADERONKE M M ABASSI PHYSICAL THERAPIST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2305209841VA
2225100000XPhysical Therapist25613MD

General Provider Information

NPI Number : 1619458122
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ADERONKE M M ABASSI PHYSICAL THERAPIST
Provider Business Mailing Address
First Line : 8017 RIVER PARK RD
Second Line :
City : BOWIE
State : MD
Zip : 20715-3343
Country : US
Telephone Number : 317-507-7934
Fax Number :
Provider Business Practice Location Address
First Line : 7420 MARLBORO PIKE
Second Line :
City : FORESTVILLE
State : MD
Zip : 20747-4343
Country : US
Telephone Number : 301-736-0240
Fax Number : 301-736-9366
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2018
Last Update Date : 08/23/2018

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