MEDICARE: MS. MONICA MUSYT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	A3984	MD

General Provider Information

NPI Number	:	1003200411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MONICA MUSYT

Provider Business Mailing Address
First Line	:	10 SHORE WALK RD
Second Line	:
City	:	RIVA
State	:	MD
Zip	:	21140-1205
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	907 SAINT CLAIRE CT
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21409-5679
Country	:	US
Telephone Number	:	410-757-4010
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2015
Last Update Date	:	03/24/2015

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