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General NPI Number Information
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NPI Number | 1134442437
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Entity Type | Individual
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Provider Name | MARY ELIZABETH D'AMATO LMT
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Gender | Female
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Dates
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Enumeration Date | 03/01/2010
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Last Update Date | 03/01/2010
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Provider Practice Location Address
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Address Line | 3905 NATIONAL DR SUITE 375
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City | BURTONSVILLE
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State | MD
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Zip | 20866-1100
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Country | US
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Telephone | 301-476-7575
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Fax |
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Provider Business Mailing Address
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Address Line | 14121 BAUER DR
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City | ROCKVILLE
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State | MD
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Zip | 20853-2120
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Country | US
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Telephone | 240-418-8454
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | M04152
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License Number State | MD
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