Provider Demographics
NPI:1548323736
Name:GOPINATHAN, REENA G (PT)
Entity type:Individual
Prefix:
First Name:REENA
Middle Name:G
Last Name:GOPINATHAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 WAYNE AVENUE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910
Mailing Address - Country:US
Mailing Address - Phone:301-650-0036
Mailing Address - Fax:301-650-0038
Practice Address - Street 1:1010 WAYNE AVENUE
Practice Address - Street 2:SUITE 110
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910
Practice Address - Country:US
Practice Address - Phone:301-650-0036
Practice Address - Fax:301-650-0038
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY032742225100000X
DCPT870644225100000X
MD21673225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist