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NPI Code Detail

MEDICARE: JILLIAN FICHMAN DPT

MEDICARE: JILLIAN FICHMAN DPT
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
1225100000XPhysical Therapist24300MD

General Provider Information

NPI Number : 1922342971
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILLIAN FICHMAN DPT
Provider Business Mailing Address
First Line : PO BOX 4058
Second Line :
City : CROFTON
State : MD
Zip : 21114-4058
Country : US
Telephone Number : 410-315-9080
Fax Number : 410-315-9080
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 :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2012
Last Update Date : 09/01/2016

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