Provider Demographics
NPI:1467861583
Name:ACOSTA, GIL PUNSALAN (RVT/RPVI)
Entity type:Individual
Prefix:DR
First Name:GIL
Middle Name:PUNSALAN
Last Name:ACOSTA
Suffix:
Gender:M
Credentials:RVT/RPVI
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:9215 SANDY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-4828
Mailing Address - Country:US
Mailing Address - Phone:301-839-1371
Mailing Address - Fax:
Practice Address - Street 1:9215 SANDY CREEK RD
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-4828
Practice Address - Country:US
Practice Address - Phone:301-839-1371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD1563412471V0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography