MEDICARE: ELIZABETH ANN HARTY LIC. DIPL. AC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	U00372	MD

General Provider Information

NPI Number	:	1326226499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH ANN HARTY LIC. DIPL. AC.

Provider Business Mailing Address
First Line	:	4108 28TH ST
Second Line	:
City	:	MOUNT RAINIER
State	:	MD
Zip	:	20712-1817
Country	:	US
Telephone Number	:	301-927-0504
Fax Number	:

Provider Business Practice Location Address
First Line	:	4108 28TH ST
Second Line	:
City	:	MOUNT RAINIER
State	:	MD
Zip	:	20712-1817
Country	:	US
Telephone Number	:	301-927-0504
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2008
Last Update Date	:	01/31/2008

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