Healthcare Provider Details

I. General information

NPI: 1770414062
Provider Name (Legal Business Name): SARAH ELIZABETH MAURANTONIO
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2507 N HOWARD ST STE 110
BALTIMORE MD
21218-6855
US

IV. Provider business mailing address

2507 N HOWARD ST STE 110
BALTIMORE MD
21218-6855
US

V. Phone/Fax

Practice location:
  • Phone: 410-914-8018
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number30865
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: