Provider Demographics
NPI:1124240668
Name:PALANISAMY, TAMIL SELVI (PT)
Entity type:Individual
Prefix:
First Name:TAMIL SELVI
Middle Name:
Last Name:PALANISAMY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 HALPINE RD
Mailing Address - Street 2:APT 1334
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1661
Mailing Address - Country:US
Mailing Address - Phone:732-500-7786
Mailing Address - Fax:
Practice Address - Street 1:201 RUSSELL AVE
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2801
Practice Address - Country:US
Practice Address - Phone:301-987-6170
Practice Address - Fax:301-987-6196
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22129225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist