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General NPI Number Information
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NPI Number | 1376748632
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Entity Type | Organization
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Legal Business Name | CHILDREN'S NATIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 07/11/2008
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Provider Practice Location Address
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Address Line | (2ND ADDRESS) SHADY GROVE OFFICE 14801 PHYSICIANS LANE
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City | ROCKVILLE
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State | MD
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Zip | 20850
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Country | US
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Telephone | 202-884-5142
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Fax | 202-884-2676
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Provider Business Mailing Address
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Address Line | DEPT OF NEUROLOGY, CNMC 111 MICHIGAN AVE NW 111 MICHIGAN AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20010-2970
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Country | US
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Telephone | 202-884-5142
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Fax | 202-884-2676
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Authorized Official
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Title or Position | DIRECTOR, SUPPPORT SERVICES, NEURO.
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Name | MRS. SANDRA MICHELLE CUSHNER WEINSTEIN
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Credential | PT, LCSW-C OR LICSW
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Telephone | 202-884-5142
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 281PC2000X
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Taxonomy Name | Children's Chronic Disease Hospital
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License Number | LC303058
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 281PC2000X
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Taxonomy Name | Children's Chronic Disease Hospital
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License Number | 14550 (PT)
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 281PC2000X
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Taxonomy Name | Children's Chronic Disease Hospital
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License Number | 0720 (LCSW-C)
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License Number State | MD
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