Provider Demographics
NPI:1043603475
Name:UNITED PHYSICAL THERAPY ASSOCIATES
Entity Type:Organization
Organization Name:UNITED PHYSICAL THERAPY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUADA
Authorized Official - Middle Name:N
Authorized Official - Last Name:HAMMADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-919-4386
Mailing Address - Street 1:7634 N ARBORY WAY
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5540
Mailing Address - Country:US
Mailing Address - Phone:301-919-4386
Mailing Address - Fax:
Practice Address - Street 1:7634 N ARBORY WAY
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5540
Practice Address - Country:US
Practice Address - Phone:301-919-4386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-10
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD=========Medicare UPIN