Provider Demographics
NPI:1902409543
Name:ANDAYA, CZARMAINE DUNGO
Entity Type:Individual
Prefix:
First Name:CZARMAINE
Middle Name:DUNGO
Last Name:ANDAYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WALTER WARD BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-1285
Mailing Address - Country:US
Mailing Address - Phone:443-512-8337
Mailing Address - Fax:
Practice Address - Street 1:11701 LIVINGSTON RD STE 202
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-5136
Practice Address - Country:US
Practice Address - Phone:443-512-8337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist