Provider Demographics
NPI:1851951073
Name:HABTEYES, HENOK BERHANU (DPT)
Entity Type:Individual
Prefix:
First Name:HENOK
Middle Name:BERHANU
Last Name:HABTEYES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9710 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1419
Mailing Address - Country:US
Mailing Address - Phone:202-375-4091
Mailing Address - Fax:
Practice Address - Street 1:9710 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-1419
Practice Address - Country:US
Practice Address - Phone:202-375-4091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT5000015225100000X
MD27534225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist