Provider Demographics
NPI:1053928713
Name:ZACUTO, GABRIELLE (PT, DPT)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:ZACUTO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 N THOMAS ST APT 400
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-2491
Mailing Address - Country:US
Mailing Address - Phone:818-665-9640
Mailing Address - Fax:
Practice Address - Street 1:6208 MONTROSE RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4119
Practice Address - Country:US
Practice Address - Phone:301-468-9343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28121261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy