MEDICARE: MS. ROBIN T TITTLEY

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	1744P3200X	Prosthetics Case Management	49002	MD

General Provider Information

NPI Number	:	1346886173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROBIN T TITTLEY

Provider Business Mailing Address
First Line	:	328 U ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20001-1722
Country	:	US
Telephone Number	:	301-526-9415
Fax Number	:

Provider Business Practice Location Address
First Line	:	1133 EAST WEST HIGHWAY (INSIDE SOLA SALON #14)
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-2091
Country	:	US
Telephone Number	:	301-526-9415
Fax Number	:

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

Provider Enumeration Date	:	11/27/2019
Last Update Date	:	11/27/2019

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Directions to “ MS. ROBIN T TITTLEY ” Practice Location

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