Provider Demographics
NPI:1558608414
Name:AZURIN, CAROLYN ABES (PT)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:ABES
Last Name:AZURIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4702 23RD PKWY
Mailing Address - Street 2:T2
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-4534
Mailing Address - Country:US
Mailing Address - Phone:646-430-0523
Mailing Address - Fax:
Practice Address - Street 1:7520 SURRATTS RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-3353
Practice Address - Country:US
Practice Address - Phone:301-856-1660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-12
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035798225100000X
NY008350225200000X
MD24368225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant