1043251580 NPI number — MRS. LINDA BERNADETTE HORN PT

Table of content: MRS. LINDA BERNADETTE HORN PT (NPI 1043251580)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043251580 NPI number — MRS. LINDA BERNADETTE HORN PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HORN
Provider First Name:
LINDA
Provider Middle Name:
BERNADETTE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LIPP
Provider Other First Name:
LINDA
Provider Other Middle Name:
BERNADETTE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1043251580
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1620 BRIMFIELD CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELDERSBURG
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21784-5965
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-795-5949
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
900 S CATON AVE
Provider Second Line Business Practice Location Address:
REHAB. SERVICES DEPT., BOX 047
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21229-5201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-368-2804
Provider Business Practice Location Address Fax Number:
410-368-3532
Provider Enumeration Date:
06/08/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  15661 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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