1407285588 NPI number — MRS. STACEY BETH ZUSKIN MS,OTR/L

Table of content: MRS. STACEY BETH ZUSKIN MS,OTR/L (NPI 1407285588)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407285588 NPI number — MRS. STACEY BETH ZUSKIN MS,OTR/L

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZUSKIN
Provider First Name:
STACEY
Provider Middle Name:
BETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS,OTR/L
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1407285588
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
228 CHANTREY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TIMONIUM
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21093-2620
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-858-8683
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6916 N CHARLES ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21204-3718
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-451-5700
Provider Business Practice Location Address Fax Number:
410-451-5703
Provider Enumeration Date:
11/08/2013

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: 225XP0200X , with the licence number:  07967 , 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)





Copyright © 2007-2025 www.npivalidator.com