Healthcare Provider Details

I. General information

NPI: 1811321938
Provider Name (Legal Business Name): CAPITAL REHABILITATION ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2013
Last Update Date: 08/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19710 FISHER AVE
POOLESVILLE MD
20837-2098
US

IV. Provider business mailing address

19710 FISHER AVE
POOLESVILLE MD
20837-2098
US

V. Phone/Fax

Practice location:
  • Phone: 301-340-0029
  • Fax:
Mailing address:
  • Phone: 301-340-0029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberH0064810
License Number StateMD

VIII. Authorized Official

Name: MS. REBECCA ARONSON
Title or Position: OWNER
Credential: MD
Phone: 301-340-0029