Provider Demographics
NPI:1508862095
Name:HERNANDEZ, ARLENE (PT)
Entity Type:Individual
Prefix:MS
First Name:ARLENE
Middle Name:
Last Name:HERNANDEZ
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 1:2306 PIONEER CT
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-2670
Mailing Address - Country:US
Mailing Address - Phone:301-839-1600
Mailing Address - Fax:301-567-1207
Practice Address - Street 1:831 UNIVERSITY BLVD E
Practice Address - Street 2:STE 34
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-2915
Practice Address - Country:US
Practice Address - Phone:301-839-1600
Practice Address - Fax:301-567-1207
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15880225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist