Provider Demographics
NPI:1518364033
Name:BAFNA, SUNETRA (MPT)
Entity Type:Individual
Prefix:
First Name:SUNETRA
Middle Name:
Last Name:BAFNA
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8380 COLESVILLE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-6255
Mailing Address - Country:US
Mailing Address - Phone:301-588-7778
Mailing Address - Fax:301-588-0843
Practice Address - Street 1:8380 COLESVILLE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-6255
Practice Address - Country:US
Practice Address - Phone:301-588-7778
Practice Address - Fax:301-588-0843
Is Sole Proprietor?:No
Enumeration Date:2014-11-26
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25243225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist