Healthcare Provider Details

I. General information

NPI: 1588815500
Provider Name (Legal Business Name): ALLISON STACY GURWITZ GREENWOOD OTR/L, ATP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON STACY GURWITZ

II. Dates (important events)

Enumeration Date: 10/08/2008
Last Update Date: 04/12/2024
Certification Date: 04/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 KERNAN DR RM 1427
BALTIMORE MD
21207-6665
US

IV. Provider business mailing address

2200 KERNAN DR RM 1427
BALTIMORE MD
21207-6665
US

V. Phone/Fax

Practice location:
  • Phone: 410-448-6896
  • Fax: 410-448-6791
Mailing address:
  • Phone: 410-448-6896
  • Fax: 410-448-6791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number05623
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: