Provider Demographics
NPI:1326024530
Name:GILLANDERS, ROBERT (DPT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:GILLANDERS
Suffix:
Gender:M
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:PO BOX 412307
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-2307
Mailing Address - Country:US
Mailing Address - Phone:914-294-4050
Mailing Address - Fax:
Practice Address - Street 1:70 JEFFERSON CT STE 102
Practice Address - Street 2:
Practice Address - City:ZION CROSSROADS
Practice Address - State:VA
Practice Address - Zip Code:22942-9604
Practice Address - Country:US
Practice Address - Phone:540-832-3061
Practice Address - Fax:540-832-3062
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305006263225100000X
DCPT870954225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCQ41413Medicare UPIN
DC016874J86Medicare PIN