1437172632 NPI number — MRS. CASSANDRA ROBIN ZURBUCH PT, DPT

Table of content: MRS. CASSANDRA ROBIN ZURBUCH PT, DPT (NPI 1437172632)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437172632 NPI number — MRS. CASSANDRA ROBIN ZURBUCH PT, DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZURBUCH
Provider First Name:
CASSANDRA
Provider Middle Name:
ROBIN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PT, DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GANNON
Provider Other First Name:
CASSANDRA
Provider Other Middle Name:
ROBIN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT, DPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1437172632
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/27/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7817 BALTIMORE NATIONAL PIKE
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
FREDERICK
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21702
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-473-4065
Provider Business Mailing Address Fax Number:
301-473-4085

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7817 BALTIMORE NATIONAL PIKE
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
FREDERICK
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-473-4065
Provider Business Practice Location Address Fax Number:
301-473-4085
Provider Enumeration Date:
07/26/2006

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:  18881 , 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)

  • Identifier: 002914900 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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