Healthcare Provider Details

I. General information

NPI: 1013736818
Provider Name (Legal Business Name): NINA KASHTELYAN P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2024
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 OLD COURT RD STE 205
PIKESVILLE MD
21208-2800
US

IV. Provider business mailing address

4000 OLD COURT RD STE 205
PIKESVILLE MD
21208-2800
US

V. Phone/Fax

Practice location:
  • Phone: 410-484-9950
  • Fax:
Mailing address:
  • Phone: 410-484-9950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NINA KASHTELYAN
Title or Position: MEDICAL DOCTOR
Credential: MD
Phone: 410-484-9950