Healthcare Provider Details

I. General information

NPI: 1689953002
Provider Name (Legal Business Name): JOAN ELLEN HERSHER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2011
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1848 REISTERSTOWN RD
PIKESVILLE MD
21208-1379
US

IV. Provider business mailing address

1848 REISTERSTOWN RD
PIKESVILLE MD
21208-1379
US

V. Phone/Fax

Practice location:
  • Phone: 443-360-5527
  • Fax: 877-353-0384
Mailing address:
  • Phone: 433-360-5527
  • Fax: 877-353-0384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberPT 0005974
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number30021
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: