Healthcare Provider Details

I. General information

NPI: 1841627726
Provider Name (Legal Business Name): INTERNATIONAL NEUROREHABILITATION INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2013
Last Update Date: 09/14/2023
Certification Date: 09/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1447 YORK RD STE 508
LUTHERVILLE MD
21093-6022
US

IV. Provider business mailing address

1447 YORK RD STE 508
LUTHERVILLE MD
21093-6022
US

V. Phone/Fax

Practice location:
  • Phone: 410-828-4629
  • Fax: 410-828-4783
Mailing address:
  • Phone: 410-828-4629
  • Fax: 410-828-4783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License NumberD0066385
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberD0066385
License Number StateMD

VIII. Authorized Official

Name: DR. DANIEL BECKER
Title or Position: DIRECTOR
Credential: M.D.
Phone: 314-369-3574