Provider Demographics
NPI:1336135284
Name:PAREZO, JAMIN M (PT)
Entity Type:Individual
Prefix:
First Name:JAMIN
Middle Name:M
Last Name:PAREZO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 W ROLLING XRDS
Mailing Address - Street 2:STE 102
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-6211
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2 W ROLLING CROSSROADS
Practice Address - Street 2:SUITE 102
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228-6208
Practice Address - Country:US
Practice Address - Phone:410-747-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2024-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21182208100000X
2251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic