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NPI Code Detail

MEDICARE: STACY ANN GOLDSTEIN OTR/L, CHT, CLT

MEDICARE: STACY ANN GOLDSTEIN OTR/L, CHT, CLT
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
1225X00000XOccupational TherapistOC013868PA
2225XH1200XHand Occupational Therapist04600MD

General Provider Information

NPI Number : 1942456546
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACY ANN GOLDSTEIN OTR/L, CHT, CLT
Provider Business Mailing Address
First Line : 911 HOLY CROSS RD
Second Line :
City : STREET
State : MD
Zip : 21154-1119
Country : US
Telephone Number : 443-223-9902
Fax Number :
Provider Business Practice Location Address
First Line : 12 MEDSTAR BLVD STE 325
Second Line :
City : BEL AIR
State : MD
Zip : 21015-1817
Country : US
Telephone Number : 410-877-8078
Fax Number : 410-877-8079
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2008
Last Update Date : 12/14/2023

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