Healthcare Provider Details

I. General information

NPI: 1447365804
Provider Name (Legal Business Name): LYNN HERKOWITZ DEUTSCH D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6205 EXECUTIVE BLVD
ROCKVILLE MD
20852-3906
US

IV. Provider business mailing address

719 KERSEY RD
SILVER SPRING MD
20902-3055
US

V. Phone/Fax

Practice location:
  • Phone: 301-770-4761
  • Fax: 301-770-4762
Mailing address:
  • Phone: 240-353-5555
  • Fax: 301-770-4762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberH38740
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: