Healthcare Provider Details

I. General information

NPI: 1629260872
Provider Name (Legal Business Name): CONSTANCE ANN NOTARO R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2007
Last Update Date: 08/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6401 YORK RD 3RD FLOOR
BALTIMORE MD
21212-2152
US

IV. Provider business mailing address

6401 YORK RD 3RD FLOOR
BALTIMORE MD
21212-2152
US

V. Phone/Fax

Practice location:
  • Phone: 410-887-3432
  • Fax: 410-337-8104
Mailing address:
  • Phone: 410-887-3432
  • Fax: 410-337-8104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberR121980
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: