Provider Demographics
NPI:1659058584
Name:PASSAFIUME, RICHARD MICHAEL JR
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:MICHAEL
Last Name:PASSAFIUME
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 HALF ST SE APT 903
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-4583
Mailing Address - Country:US
Mailing Address - Phone:862-264-8553
Mailing Address - Fax:
Practice Address - Street 1:115 SUDBROOK LN STE A
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-4184
Practice Address - Country:US
Practice Address - Phone:410-358-1997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist