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General NPI Number Information
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NPI Number | 1720424146
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Entity Type | Organization
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Legal Business Name | AUDIOLOGY CENTER OF MARYLAND INC
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Dates
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Enumeration Date | 05/13/2013
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Last Update Date | 03/06/2020
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Provider Practice Location Address
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Address Line | 11808 ETON MANOR DR #202
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City | GERMANTOWN
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State | MD
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Zip | 20876-3934
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Country | US
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Telephone | 201-247-6608
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Fax |
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Provider Business Mailing Address
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Address Line | 11808 ETON MANOR DR #202
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City | GERMANTOWN
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State | MD
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Zip | 20876-3934
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Country | US
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Telephone | 201-247-6608
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF AUDIOLOGY
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Name | DR. MARYAM ESMAELI
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Credential | SCD., CCC-A
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Telephone | 201-247-6608
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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