MEDICARE: RANDI PINNO AU.D.

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	231H00000X	Audiologist	01389	MD

General Provider Information

NPI Number	:	1932550456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANDI PINNO AU.D.

Provider Business Mailing Address
First Line	:	6915 LAUREL BOWIE RD STE 304
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20715-1725
Country	:	US
Telephone Number	:	301-860-1124
Fax Number	:	240-929-4640

Provider Business Practice Location Address
First Line	:	22738 MAPLE RD STE 109
Second Line	:
City	:	LEXINGTON PARK
State	:	MD
Zip	:	20653-3347
Country	:	US
Telephone Number	:	410-535-0024
Fax Number	:	240-237-8573

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

Provider Enumeration Date	:	06/27/2016
Last Update Date	:	09/20/2018

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