Provider Demographics
NPI:1477123370
Name:NEUFORM PHYSIOTHERAPY LLC
Entity Type:Organization
Organization Name:NEUFORM PHYSIOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CEO
Authorized Official - Prefix:
Authorized Official - First Name:RINKU
Authorized Official - Middle Name:
Authorized Official - Last Name:KURIL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, ECS, RMSK
Authorized Official - Phone:410-883-7208
Mailing Address - Street 1:6860 OLNEY LAYTONSVILLE RD UNIT 3
Mailing Address - Street 2:
Mailing Address - City:LAYTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20882-1921
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6860 OLNEY LAYTONSVILLE RD UNIT 3
Practice Address - Street 2:
Practice Address - City:LAYTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20882-1921
Practice Address - Country:US
Practice Address - Phone:301-570-7970
Practice Address - Fax:301-570-7971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-01
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, ClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1972844611OtherNPPES