Healthcare Provider Details

I. General information

NPI: 1407068356
Provider Name (Legal Business Name): ARIANNA Z BERKOWITZ MAC, MPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 01/06/2021
Certification Date: 01/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9509 FOOTPRINT PL
COLUMBIA MD
21046-2052
US

IV. Provider business mailing address

9509 FOOTPRINT PL
COLUMBIA MD
21046-2052
US

V. Phone/Fax

Practice location:
  • Phone: 443-745-1560
  • Fax:
Mailing address:
  • Phone: 443-745-1560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number19264
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberU01718
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: