Provider Demographics
NPI:1639348840
Name:ROSEN HOFFBERG REHABILITATION AND PAIN MANAGEMENT ASSOCIATES PA
Entity Type:Organization
Organization Name:ROSEN HOFFBERG REHABILITATION AND PAIN MANAGEMENT ASSOCIATES PA
Other - Org Name:ROSEN HOFFBERG REHABILITATION AND PAIN MANAGEMENT ASSOCIATES PA PHYSIC
Other - Org Type:Other Name
Authorized Official - Title/Position:SECRETARY TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MARCIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-821-7775
Mailing Address - Street 1:8415 BELLONE LANE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2066
Mailing Address - Country:US
Mailing Address - Phone:410-821-7775
Mailing Address - Fax:410-821-1320
Practice Address - Street 1:8415 BELLONE LANE
Practice Address - Street 2:SUITE 201
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-2066
Practice Address - Country:US
Practice Address - Phone:410-821-7775
Practice Address - Fax:410-821-1320
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROSEN HOFFBERG REHABILITATION AND PAIN MANAGEMENT ASSOCIATES PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-22
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD89NXROOtherCAREFIRST BCBS
MD404930600Medicaid
MD407861600Medicaid
MD90TGROOtherCAREFIRST BCBS
MD453648700Medicaid
MDK552ROOtherCAREFIRST BCBS
MD453648700Medicaid
MD89NXROOtherCAREFIRST BCBS