Provider Demographics
NPI:1609964428
Name:FARRELL, SHEILA (PT)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:
Last Name:FARRELL
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 1:8218 WISCONSIN AVE
Mailing Address - Street 2:STE 218
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-3107
Mailing Address - Country:US
Mailing Address - Phone:301-215-7055
Mailing Address - Fax:301-961-5598
Practice Address - Street 1:8218 WISCONSIN AVE
Practice Address - Street 2:STE 218
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3107
Practice Address - Country:US
Practice Address - Phone:301-215-7055
Practice Address - Fax:301-961-5598
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP22412225100000X
MD18189225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD18189Medicaid
MDJ0900001OtherCAREFIRST
MDJ522SGOtherBC/BS F.E.P.
MD3247081OtherAETNA
MD2121900OtherMAMSI
MDJ522SGOtherBC/BS F.E.P.