Healthcare Provider Details

I. General information

NPI: 1477419505
Provider Name (Legal Business Name): ADALBERTO PRINS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9411 PHILADELPHIA RD STE H-K
ROSEDALE MD
21237-4168
US

IV. Provider business mailing address

303 LYNDHURST ST
BALTIMORE MD
21229-2950
US

V. Phone/Fax

Practice location:
  • Phone: 410-343-9469
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA2660
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: