Provider Demographics
NPI:1477285500
Name:GARGUILO, EMILY JOSPEHINE (DPT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:JOSPEHINE
Last Name:GARGUILO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8040 STONE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-2990
Mailing Address - Country:US
Mailing Address - Phone:240-586-9914
Mailing Address - Fax:
Practice Address - Street 1:10 LIGHT ST STE 4
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-1435
Practice Address - Country:US
Practice Address - Phone:410-202-8581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29007225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist