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NPI Code Detail

MEDICARE: CHESAPEAKE BAY AQUATIC & PHYSICAL THERAPY, INC

MEDICARE: CHESAPEAKE BAY AQUATIC & PHYSICAL THERAPY, INC
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
1225X00000XOccupational Therapist
2225100000XPhysical Therapist

General Provider Information

NPI Number : 1811229412
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHESAPEAKE BAY AQUATIC & PHYSICAL THERAPY, INC
Provider Business Mailing Address
First Line : PO BOX 4058
Second Line :
City : CROFTON
State : MD
Zip : 21114-4058
Country : US
Telephone Number : 301-262-5852
Fax Number : 301-262-3173
Provider Business Practice Location Address
First Line : 100 WHITE MARSH PARK DR
Second Line :
City : BOWIE
State : MD
Zip : 20715-4361
Country : US
Telephone Number : 301-262-5852
Fax Number : 301-262-3173
Authorized Official
Title or Position : DIRECTOR OF OPERATIONS/PT
Name : MS. DANIELLE GOLDSTEIN
Credential : M.P.T.
Telephone Number : 301-498-2212
Provider Enumeration Date : 02/05/2010
Last Update Date : 11/12/2020

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Directions to “CHESAPEAKE BAY AQUATIC & PHYSICAL THERAPY, INC ” Practice Location

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