MEDICARE: MRS. ADINA BENYOWITZ MS, OTR/L

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	225X00000X	Occupational Therapist	07882	MD

General Provider Information

NPI Number	:	1730742461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ADINA BENYOWITZ MS, OTR/L

Provider Business Mailing Address
First Line	:	3316 CLARKS LN APT A
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215-2519
Country	:	US
Telephone Number	:	410-370-3711
Fax Number	:

Provider Business Practice Location Address
First Line	:	1711 LANDRAKE RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21204-1822
Country	:	US
Telephone Number	:	410-887-3568
Fax Number	:

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

Provider Enumeration Date	:	04/18/2019
Last Update Date	:	04/18/2019

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