Healthcare Provider Details

I. General information

NPI: 1336879568
Provider Name (Legal Business Name): TAYLOR LYNN HAUDE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2022
Last Update Date: 06/11/2022
Certification Date: 06/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4470 REGENCY PL STE 100
WHITE PLAINS MD
20695-3085
US

IV. Provider business mailing address

87 FOREST GLEN DR
ROCHESTER NY
14612-2280
US

V. Phone/Fax

Practice location:
  • Phone: 301-934-5336
  • Fax:
Mailing address:
  • Phone: 585-402-1307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: