Provider Demographics
NPI:1326499229
Name:GAYTAN, ARACELI (PT)
Entity Type:Individual
Prefix:
First Name:ARACELI
Middle Name:
Last Name:GAYTAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 TARLETON WAY
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-2503
Mailing Address - Country:US
Mailing Address - Phone:915-373-2004
Mailing Address - Fax:
Practice Address - Street 1:1717 TARLETON WAY
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-2503
Practice Address - Country:US
Practice Address - Phone:915-373-2004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-22
Last Update Date:2022-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1162396225100000X
MD28045225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist