Healthcare Provider Details

I. General information

NPI: 1801562673
Provider Name (Legal Business Name): PD ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2021
Last Update Date: 08/20/2021
Certification Date: 07/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 W ROLLING XRDS STE 206
CATONSVILLE MD
21228-6211
US

IV. Provider business mailing address

7831 TAGGART CT
ELKRIDGE MD
21075-8100
US

V. Phone/Fax

Practice location:
  • Phone: 410-402-9990
  • Fax: 410-402-9991
Mailing address:
  • Phone: 773-717-3356
  • Fax: 217-670-6152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: PARMINDER SINGH
Title or Position: OWNER
Credential:
Phone: 410-402-9990