Provider Demographics
NPI:1619507100
Name:UNIVERSITY OF MARYLAND NEUROLOGY ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:UNIVERSITY OF MARYLAND NEUROLOGY ASSOCIATES, P.A.
Other - Org Name:UNIVERSITY OF MARYLAND NEUROLOGY ASSOCIATES BEHAVIORAL HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSOCIATE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLIFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-499-6131
Mailing Address - Street 1:250 W PRATT ST STE 500
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-6804
Mailing Address - Country:US
Mailing Address - Phone:667-214-1069
Mailing Address - Fax:
Practice Address - Street 1:16 S EUTAW ST FL 3
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1606
Practice Address - Country:US
Practice Address - Phone:410-328-4323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF MARYLAND NEUROLOGY ASSOCIATES, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-23
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty