Provider Demographics
NPI:1598055568
Name:ROCHELLE S. HARDY, M.D., P.C.
Entity Type:Organization
Organization Name:ROCHELLE S. HARDY, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROCHELLE
Authorized Official - Middle Name:S
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PC
Authorized Official - Phone:301-249-2700
Mailing Address - Street 1:7404 EXECUTIVE PL
Mailing Address - Street 2:SUITE 502
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-6238
Mailing Address - Country:US
Mailing Address - Phone:301-249-2700
Mailing Address - Fax:301-249-4559
Practice Address - Street 1:7404 EXECUTIVE PL
Practice Address - Street 2:SUITE 502
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-6238
Practice Address - Country:US
Practice Address - Phone:301-249-2700
Practice Address - Fax:301-249-4559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0037391208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD549391900Medicaid