Healthcare Provider Details

I. General information

NPI: 1346662038
Provider Name (Legal Business Name): JERMANY AND ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2014
Last Update Date: 01/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3355 SAINT JOHNS LN SUITE F
ELLICOTT CITY MD
21042-2605
US

IV. Provider business mailing address

3355 SAINT JOHNS LN SUITE F
ELLICOTT CITY MD
21042-2605
US

V. Phone/Fax

Practice location:
  • Phone: 443-272-1541
  • Fax: 410-480-0110
Mailing address:
  • Phone: 443-272-1541
  • Fax: 410-480-0110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberD34156
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MERTINE R. JERMANY
Title or Position: CEO
Credential: M.D.
Phone: 443-272-1541