Provider Demographics
NPI:1629458443
Name:GNYAWALI, DINUP (PTA)
Entity Type:Individual
Prefix:
First Name:DINUP
Middle Name:
Last Name:GNYAWALI
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6339 WINDHARP WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-4535
Mailing Address - Country:US
Mailing Address - Phone:443-341-7172
Mailing Address - Fax:
Practice Address - Street 1:6339 WINDHARP WAY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-4535
Practice Address - Country:US
Practice Address - Phone:443-341-7172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-06
Last Update Date:2015-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA3706225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant