Healthcare Provider Details

I. General information

NPI: 1528750353
Provider Name (Legal Business Name): TAYLOR KASOFF RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 05/12/2026
Certification Date: 12/16/2025
Deactivation Date: 12/16/2025
Reactivation Date: 05/12/2026

III. Provider practice location address

2400 W BELVEDERE AVE
BALTIMORE MD
21215-5216
US

IV. Provider business mailing address

2400 W BELVEDERE AVE
BALTIMORE MD
21215-5216
US

V. Phone/Fax

Practice location:
  • Phone: 410-601-9000
  • Fax:
Mailing address:
  • Phone: 410-601-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDX5390
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: