Provider Demographics
NPI:1255044806
Name:ARGUELLES, KENNETH GABON
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:GABON
Last Name:ARGUELLES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3245 ESCAPADE CIR
Mailing Address - Street 2:
Mailing Address - City:RIVA
Mailing Address - State:MD
Mailing Address - Zip Code:21140-1307
Mailing Address - Country:US
Mailing Address - Phone:516-451-9828
Mailing Address - Fax:
Practice Address - Street 1:7611 CRAIN HWY STE C-170
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-4258
Practice Address - Country:US
Practice Address - Phone:443-481-1140
Practice Address - Fax:301-296-3129
Is Sole Proprietor?:No
Enumeration Date:2022-12-28
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist