MEDICARE: MRS. CHRISTIANNE CABANGON PT

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
1	225100000X	Physical Therapist	PT870713	DC

General Provider Information

NPI Number	:	1942574116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTIANNE CABANGON PT

Provider Business Mailing Address
First Line	:	4863 SAINT BARNABAS RD
Second Line	:	APT 7
City	:	TEMPLE HILLS
State	:	MD
Zip	:	20748-4648
Country	:	US
Telephone Number	:	240-330-3544
Fax Number	:

Provider Business Practice Location Address
First Line	:	4863 SAINT BARNABAS RD
Second Line	:	APT 7
City	:	TEMPLE HILLS
State	:	MD
Zip	:	20748-4648
Country	:	US
Telephone Number	:	240-330-3544
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2012
Last Update Date	:	03/05/2012

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