Healthcare Provider Details

I. General information

NPI: 1144680265
Provider Name (Legal Business Name): DEVASHREE VORA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4922 LASALLE RD
HYATTSVILLE MD
20782-3302
US

IV. Provider business mailing address

416 E 30TH ST
BALTIMORE MD
21218-3934
US

V. Phone/Fax

Practice location:
  • Phone: 301-864-2333
  • Fax: 877-828-2060
Mailing address:
  • Phone: 410-889-0727
  • Fax: 410-889-0729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number25886
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: