Provider Demographics
NPI:1558524736
Name:LANCASTER, BERNITA (MPT)
Entity Type:Individual
Prefix:
First Name:BERNITA
Middle Name:
Last Name:LANCASTER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7335 BRANCHWOOD TER
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-2152
Mailing Address - Country:US
Mailing Address - Phone:301-717-7360
Mailing Address - Fax:
Practice Address - Street 1:7335 BRANCHWOOD TER
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-2152
Practice Address - Country:US
Practice Address - Phone:301-717-7360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20167225100000X
DCPT870183225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist