1194736819 NPI number — HOWARD COUNTY NEONATAL SERVICES SERIES

Table of content: (NPI 1194736819)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194736819 NPI number — HOWARD COUNTY NEONATAL SERVICES SERIES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOWARD COUNTY NEONATAL SERVICES SERIES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HOWARD COUNTY NEONATAL ASSOCIATES, PLLC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194736819
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 64208
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21264-4208
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-828-0442
Provider Business Mailing Address Fax Number:
703-289-1414

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5755 CEDAR LN
Provider Second Line Business Practice Location Address:
HCGH NICU
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21044-2912
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-740-7557
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BLECHMAN
Authorized Official First Name:
GARY
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
410-740-7557

Provider Taxonomy Codes

  • Taxonomy code: 2080N0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 363LN0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)





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