Provider Demographics
NPI:1578642237
Name:MCELFRESH, JUDY A (PT)
Entity Type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:A
Last Name:MCELFRESH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8813 WALTHAM WOODS RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-2450
Mailing Address - Country:US
Mailing Address - Phone:410-882-9999
Mailing Address - Fax:410-665-7342
Practice Address - Street 1:8813 WALTHAM WOODS RD
Practice Address - Street 2:SUITE 103
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-2450
Practice Address - Country:US
Practice Address - Phone:410-882-9999
Practice Address - Fax:410-665-7342
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD15566225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD15566OtherLICENSE#
MDJ836Medicare PIN