Provider Demographics
NPI:1225257561
Name:PADEN-LIFE-CARE LLC
Entity Type:Organization
Organization Name:PADEN-LIFE-CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:VABIAN
Authorized Official - Middle Name:LEWITT
Authorized Official - Last Name:PADEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-682-5440
Mailing Address - Street 1:2300 OXFORD SHIRE CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-3215
Mailing Address - Country:US
Mailing Address - Phone:301-843-1279
Mailing Address - Fax:301-638-5512
Practice Address - Street 1:2300 OXFORD SHIRE CT
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-3215
Practice Address - Country:US
Practice Address - Phone:301-843-1279
Practice Address - Fax:301-638-5512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0060744208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty