Healthcare Provider Details

I. General information

NPI: 1750390621
Provider Name (Legal Business Name): BERNADETTE WILLIAMS YORK PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BERNADETTE WILLIAMS YORK PT

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13946 BALTIMORE AVE
LAUREL MD
20707-5000
US

IV. Provider business mailing address

13946 BALTIMORE AVE
LAUREL MD
20707-5000
US

V. Phone/Fax

Practice location:
  • Phone: 301-498-2212
  • Fax: 301-498-2213
Mailing address:
  • Phone: 301-498-2212
  • Fax: 301-498-2213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number16424
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: