Healthcare Provider Details

I. General information

NPI: 1043644560
Provider Name (Legal Business Name): CAREN DINSHAH PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2013
Last Update Date: 03/09/2021
Certification Date: 03/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7704 QUARTERFIELD RD STE 1
GLEN BURNIE MD
21061-4412
US

IV. Provider business mailing address

1714 USHER PL
CROFTON MD
21114-2316
US

V. Phone/Fax

Practice location:
  • Phone: 207-944-8070
  • Fax:
Mailing address:
  • Phone: 207-944-8070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251E1300X
TaxonomyClinical Electrophysiology Physical Therapist
License Number27549
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPA4118
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: