Basic Information
Provider Information
NPI: 1427595107
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GIPE
FirstName: ANTHONY
MiddleName: ALEXANDER
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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Mailing Information
Address1: 9216 LAWNVIEW LN
Address2:  
City: LAUREL
State: MD
PostalCode: 207082538
CountryCode: US
TelephoneNumber: 3015204116
FaxNumber:  
Practice Location
Address1: 5530 WISCONSIN AVE
Address2: SUITE #1650
City: CHEVY CHASE
State: MD
PostalCode: 208154404
CountryCode: US
TelephoneNumber: 3019869100
FaxNumber: 3019869101
Other Information
ProviderEnumerationDate: 01/19/2017
LastUpdateDate: 01/19/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X26234MDY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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