MEDICARE: TERESITA BAGUIO

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	2251G0304X	Geriatric Physical Therapist	18363	MD

General Provider Information

NPI Number	:	1972816072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESITA BAGUIO

Provider Business Mailing Address
First Line	:	10015 OLD COLUMBIA RD
Second Line	:	SUITE B-215
City	:	COLUMBIA
State	:	MD
Zip	:	21046-1703
Country	:	US
Telephone Number	:	410-312-7631
Fax Number	:	410-510-1779

Provider Business Practice Location Address
First Line	:	10 N ROCK GLEN RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21229-3250
Country	:	US
Telephone Number	:	410-646-2100
Fax Number	:	410-510-1779

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

Provider Enumeration Date	:	07/17/2010
Last Update Date	:	07/17/2010

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Directions to “ TERESITA BAGUIO ” Practice Location

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