Provider Demographics
NPI:1073750188
Name:GEORGALLAS, LAMBROS (DPT)
Entity Type:Individual
Prefix:DR
First Name:LAMBROS
Middle Name:
Last Name:GEORGALLAS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11120 NEW HAMPSHIRE AVENUE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904
Mailing Address - Country:US
Mailing Address - Phone:301-592-8200
Mailing Address - Fax:301-592-8300
Practice Address - Street 1:11120 NEW HAMPSHIRE AVE STE 200
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2679
Practice Address - Country:US
Practice Address - Phone:301-592-8200
Practice Address - Fax:301-592-8300
Is Sole Proprietor?:No
Enumeration Date:2009-01-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031885225100000X
MD22800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist