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NPI Code Detail

MEDICARE: JANNET W KABARU PTA

MEDICARE: JANNET W KABARU PTA
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
1225200000XPhysical Therapy AssistantA3709MD

General Provider Information

NPI Number : 1942571039
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANNET W KABARU PTA
Provider Business Mailing Address
First Line : 321 LAKE VISTA CIR
Second Line : APT F
City : COCKEYSVILLE
State : MD
Zip : 21030-5204
Country : US
Telephone Number : 443-600-8139
Fax Number :
Provider Business Practice Location Address
First Line : 321 LAKE VISTA CIR
Second Line : APT F
City : COCKEYSVILLE
State : MD
Zip : 21030-5204
Country : US
Telephone Number : 443-600-8139
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2012
Last Update Date : 01/20/2012

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