Provider Demographics
NPI:1659484400
Name:CENTER FOR EATING DISORDERS PA
Entity Type:Organization
Organization Name:CENTER FOR EATING DISORDERS PA
Other - Org Name:CED PA
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRANDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-938-5252
Mailing Address - Street 1:101 SCHILLING RD STE 40A
Mailing Address - Street 2:
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21031-1137
Mailing Address - Country:US
Mailing Address - Phone:410-938-5252
Mailing Address - Fax:410-938-8461
Practice Address - Street 1:101 SCHILLING ROAD
Practice Address - Street 2:SUITE 40A
Practice Address - City:HUNT VALLEY
Practice Address - State:MD
Practice Address - Zip Code:21031-7739
Practice Address - Country:US
Practice Address - Phone:410-427-3900
Practice Address - Fax:410-938-8461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD190921500Medicaid
K522CEOtherCAREFIRST
MDK522Medicare ID - Type Unspecified