Provider Demographics
NPI:1376716423
Name:NEURO ORTHOPEDIC PHYSICAL THERAPY PA
Entity Type:Organization
Organization Name:NEURO ORTHOPEDIC PHYSICAL THERAPY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NKEM
Authorized Official - Middle Name:M
Authorized Official - Last Name:OKORAFOR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:301-552-5301
Mailing Address - Street 1:9841 GREENBELT RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-6269
Mailing Address - Country:US
Mailing Address - Phone:301-552-5301
Mailing Address - Fax:301-552-5302
Practice Address - Street 1:9841 GREENBELT RD
Practice Address - Street 2:SUITE 205
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-6269
Practice Address - Country:US
Practice Address - Phone:301-552-5301
Practice Address - Fax:301-552-5302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17680111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD490092Medicare PIN