Provider Demographics
NPI:1891015772
Name:ABENDAN, GENEVIEVE GIZELLE MARCOS (RPT)
Entity Type:Individual
Prefix:MS
First Name:GENEVIEVE GIZELLE
Middle Name:MARCOS
Last Name:ABENDAN
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9932 SHELBURNE TER APT 312
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-5348
Mailing Address - Country:US
Mailing Address - Phone:407-334-1324
Mailing Address - Fax:
Practice Address - Street 1:130 HOSPITAL RD STE 103
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-4029
Practice Address - Country:US
Practice Address - Phone:410-535-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23207225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist