Provider Demographics
NPI:1548640287
Name:HAHN, GINA DECARO (DPT)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:DECARO
Last Name:HAHN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1216 SHESLEY RD
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:MD
Mailing Address - Zip Code:21037-4659
Mailing Address - Country:US
Mailing Address - Phone:410-456-6420
Mailing Address - Fax:
Practice Address - Street 1:1834 GEORGE AVE
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-4103
Practice Address - Country:US
Practice Address - Phone:443-441-0631
Practice Address - Fax:443-320-4125
Is Sole Proprietor?:No
Enumeration Date:2015-06-08
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD282622251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic