Provider Demographics
NPI:1568515872
Name:JOHNS HOPKINS UNIVERSITY
Entity Type:Organization
Organization Name:JOHNS HOPKINS UNIVERSITY
Other - Org Name:KENNEDY KRIEGER INSTITUTE
Other - Org Type:Other Name
Authorized Official - Title/Position:FELLOW PEDIATRIC NEUROLOGY AND DEV
Authorized Official - Prefix:DR
Authorized Official - First Name:VIVECK
Authorized Official - Middle Name:
Authorized Official - Last Name:BALUJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-923-9162
Mailing Address - Street 1:1020 PARK AVE APT 903
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-5645
Mailing Address - Country:US
Mailing Address - Phone:409-750-1843
Mailing Address - Fax:
Practice Address - Street 1:707 N BROADWAY
Practice Address - Street 2:103B
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21205-1832
Practice Address - Country:US
Practice Address - Phone:409-750-1843
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital