MEDICARE: NEISWANGER MANAGEMENT SERVICES

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	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1831260751
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEISWANGER MANAGEMENT SERVICES

Provider Business Mailing Address
First Line	:	4922 LASALLE RD
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20782-3302
Country	:	US
Telephone Number	:	301-864-2333
Fax Number	:	301-864-1377

Provider Business Practice Location Address
First Line	:	4922 LASALLE RD
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20782-3302
Country	:	US
Telephone Number	:	301-864-2333
Fax Number	:	301-864-1377

Authorized Official
Title or Position	:	COO
Name	:	MATT NEISWANGER
Credential	:
Telephone Number	:	301-864-1035

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	08/22/2020

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Directions to “NEISWANGER MANAGEMENT SERVICES ” Practice Location

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