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NPI Code Detail

MEDICARE: MRS. MARY GRACE SINCHIOCO MADURO

MEDICARE: MRS. MARY GRACE SINCHIOCO MADURO
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
1225100000XPhysical Therapist21974MD

General Provider Information

NPI Number : 1538331772
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY GRACE SINCHIOCO MADURO
Provider Business Mailing Address
First Line : 3290 N RIDGE RD
Second Line : SUITE 290
City : ELLICOTT CITY
State : MD
Zip : 21043-3655
Country : US
Telephone Number : 410-750-9006
Fax Number : 410-750-0787
Provider Business Practice Location Address
First Line : 3514 N FOWLER AVE
Second Line :
City : SILVER CITY
State : NM
Zip : 88061-7210
Country : US
Telephone Number : 575-388-3127
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2008
Last Update Date : 03/27/2008

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Directions to “ MRS. MARY GRACE SINCHIOCO MADURO ” Practice Location

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