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General NPI Number Information
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NPI Number | 1528525318
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Entity Type | Individual
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Provider Name | ELISA ROCHELLE DALUPANG PT
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Gender | Female
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Dates
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Enumeration Date | 02/27/2019
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Last Update Date | 04/06/2023
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Provider Practice Location Address
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Address Line | 8507 MAPLEVILLE RD
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City | BOONSBORO
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State | MD
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Zip | 21713-1818
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Country | US
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Telephone | 301-671-5182
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Fax | 301-671-5150
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Provider Business Mailing Address
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Address Line | 5903 LEBEN DR
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City | FREDERICK
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State | MD
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Zip | 21703-2899
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Country | US
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Telephone | 443-683-0473
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 22933
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License Number State | MD
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