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NPI Code Detail

MEDICARE: JESSICA ROBINSON

MEDICARE: JESSICA ROBINSON
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 TherapistA4246MD

General Provider Information

NPI Number : 1619593787
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA ROBINSON
Provider Business Mailing Address
First Line : 1479 MAIN ST
Second Line :
City : NEW PARK
State : PA
Zip : 17352-9491
Country : US
Telephone Number : 443-528-1129
Fax Number :
Provider Business Practice Location Address
First Line : 2525 POT SPRING RD
Second Line :
City : LUTHERVILLE TIMONIUM
State : MD
Zip : 21093-2778
Country : US
Telephone Number : 410-308-9702
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2020
Last Update Date : 06/24/2020

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