MEDICARE: KENNEDY KRIEGER INSTITUTE

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	284300000X	Special Hospital	30036	MD

General Provider Information

NPI Number	:	1699778415
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENNEDY KRIEGER INSTITUTE

Provider Business Mailing Address
First Line	:	700 N BROADWAY
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21205-1806
Country	:	US
Telephone Number	:	443-923-9200
Fax Number	:	443-923-1875

Provider Business Practice Location Address
First Line	:	700 N BROADWAY
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21205-1806
Country	:	US
Telephone Number	:	443-923-9200
Fax Number	:	443-923-1875

Authorized Official
Title or Position	:	VICE PRESIDENT OF FINANCE
Name	:	MR. MICHAEL NEUMAN
Credential	:
Telephone Number	:	443-923-9200

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	08/22/2020

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