Healthcare Provider Details

I. General information

NPI: 1619986502
Provider Name (Legal Business Name): LORI ARONOW MENDOZA DSCPT, PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

1400 FOREST GLEN RD SUITE 1400
SILVER SPRING MD
20910-1459
US

IV. Provider business mailing address

1400 FOREST GLEN RD SUITE 1400
SILVER SPRING MD
20910-1459
US

V. Phone/Fax

Practice location:
  • Phone: 301-589-3324
  • Fax: 301-681-7575
Mailing address:
  • Phone: 301-589-3324
  • Fax: 301-681-7575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number15021
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: