Provider Demographics
NPI:1952540023
Name:ABIY PHYSICAL THERAPY & REHAB LLC
Entity Type:Organization
Organization Name:ABIY PHYSICAL THERAPY & REHAB LLC
Other - Org Name:N/A
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ABIYU
Authorized Official - Middle Name:
Authorized Official - Last Name:TESFAYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-518-9764
Mailing Address - Street 1:10604 GLENHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-4129
Mailing Address - Country:US
Mailing Address - Phone:301-518-9764
Mailing Address - Fax:301-649-0705
Practice Address - Street 1:801 WAYNE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4450
Practice Address - Country:US
Practice Address - Phone:301-518-9764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-13
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17775261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy