Provider Demographics
NPI:1548413602
Name:ROBERTS, HADASSA (PT)
Entity type:Individual
Prefix:MRS
First Name:HADASSA
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:HADASSA
Other - Middle Name:
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1738 ELTON RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-1725
Mailing Address - Country:US
Mailing Address - Phone:301-434-1980
Mailing Address - Fax:301-434-1981
Practice Address - Street 1:1738 ELTON RD
Practice Address - Street 2:SUITE 230
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-1725
Practice Address - Country:US
Practice Address - Phone:301-434-1980
Practice Address - Fax:301-434-1981
Is Sole Proprietor?:No
Enumeration Date:2008-11-02
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21301225100000X
VA2305203763225100000X
DCPT870629225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
46950034OtherCAREFIRST NCA
PT870629OtherDC LICENSE
21301OtherMARYLAND LICENSE
2305203763OtherVIRGINIA LICENSE