Healthcare Provider Details

I. General information

NPI: 1134099864
Provider Name (Legal Business Name): JHU RESPIRATORY DIV
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2025
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 ALPHA COMMONS DR
BALTIMORE MD
21224-1750
US

IV. Provider business mailing address

6201 GREENLEIGH AVE
MIDDLE RIVER MD
21220-2004
US

V. Phone/Fax

Practice location:
  • Phone: 410-550-0100
  • Fax:
Mailing address:
  • Phone: 410-955-0000
  • Fax: 410-500-4266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: NICHOLAS GIARRATANO
Title or Position: DIRECTOR, PROVIDER ENROLLMENT
Credential:
Phone: 410-933-0000