Provider Demographics
NPI:1033236021
Name:HART, BARBARA BONITA (BSC, PT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:BONITA
Last Name:HART
Suffix:
Gender:F
Credentials:BSC, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 FOREST GLEN RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1459
Mailing Address - Country:US
Mailing Address - Phone:301-589-3324
Mailing Address - Fax:301-681-7575
Practice Address - Street 1:1400 FOREST GLEN RD
Practice Address - Street 2:SUITE 400
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-1459
Practice Address - Country:US
Practice Address - Phone:301-589-3324
Practice Address - Fax:301-681-7575
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD16100OtherDEPT OF HEALTH & MENTAL H