Provider Demographics
NPI:1871304832
Name:GARAY, PABLO ANTONIO (PT)
Entity type:Individual
Prefix:
First Name:PABLO
Middle Name:ANTONIO
Last Name:GARAY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3308 BERET LN
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-3024
Mailing Address - Country:US
Mailing Address - Phone:301-461-3762
Mailing Address - Fax:
Practice Address - Street 1:13975 CONNECTICUT AVE STE 300
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-2921
Practice Address - Country:US
Practice Address - Phone:301-598-7420
Practice Address - Fax:301-598-7432
Is Sole Proprietor?:No
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30267225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist