Provider Demographics
NPI:1497291595
Name:NICKENS, GARIMA SRIVASTAVA (DPT)
Entity Type:Individual
Prefix:DR
First Name:GARIMA
Middle Name:SRIVASTAVA
Last Name:NICKENS
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 1:25508 JOY LN
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:MD
Mailing Address - Zip Code:20872-2626
Mailing Address - Country:US
Mailing Address - Phone:240-462-1710
Mailing Address - Fax:
Practice Address - Street 1:3120 GRACEFIELD RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-5810
Practice Address - Country:US
Practice Address - Phone:301-572-8372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist