1598952004 NPI number — MS. CHRISTINA ELISABETH EPPINGHAUS PHYSICAL THERAPIST

Table of content: MS. CHRISTINA ELISABETH EPPINGHAUS PHYSICAL THERAPIST (NPI 1598952004)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598952004 NPI number — MS. CHRISTINA ELISABETH EPPINGHAUS PHYSICAL THERAPIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EPPINGHAUS
Provider First Name:
CHRISTINA
Provider Middle Name:
ELISABETH
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PHYSICAL THERAPIST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JOHNSTON
Provider Other First Name:
CHRISTINA
Provider Other Middle Name:
ELISABETH
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1598952004
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 E JOPPA RD STE LL102
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOWSON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21286-3105
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-832-2706
Provider Business Mailing Address Fax Number:
410-832-2706

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5 RUFFED GROUSE CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOWSON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21286-1669
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-832-2706
Provider Business Practice Location Address Fax Number:
410-832-2706
Provider Enumeration Date:
09/28/2007

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:  15148 , 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)





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