Healthcare Provider Details

I. General information

NPI: 1316353394
Provider Name (Legal Business Name): INTERNATIONAL NEUROREHABILITATION INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2014
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
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 TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DANIEL BECKER
Title or Position: DIRECTOR
Credential: M.D.
Phone: 410-828-4629