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General NPI Number Information
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NPI Number | 1720450224
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Entity Type | Organization
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Legal Business Name | MERAKI PHYSICAL THERAPY AND PILATES, LLC
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Dates
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Enumeration Date | 10/22/2015
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Last Update Date | 10/22/2015
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Provider Practice Location Address
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Address Line | 5002 LAWNDALE AVE STE A
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City | BALTIMORE
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State | MD
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Zip | 21210-2086
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Country | US
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Telephone | 410-812-5148
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Fax |
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Provider Business Mailing Address
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Address Line | 802 S POTOMAC ST
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City | BALTIMORE
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State | MD
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Zip | 21224-3957
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Country | US
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Telephone | 410-812-5148
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ASYA FAYE HANKIN
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Credential | PT, DPT
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Telephone | 410-812-5148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 24529
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License Number State | MD
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