Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 24049 | MD |
NPI | 1053724468 |
---|---|
Provider Name | Priya Pillai |
First Address | Silver Spring, MD 20910 |
Second Address | Silver Spring, MD 20910 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2014 |
Last Update Date | 04/06/2014 |