Provider Demographics
NPI:1841408267
Name:FIRLIE, MARIALENA NMN (MHS, PT)
Entity Type:Individual
Prefix:
First Name:MARIALENA
Middle Name:NMN
Last Name:FIRLIE
Suffix:
Gender:F
Credentials:MHS, PT
Other - Prefix:
Other - First Name:MARIALENA
Other - Middle Name:NMN
Other - Last Name:LUPERINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MHS, PT
Mailing Address - Street 1:2428 HARTFELL RD
Mailing Address - Street 2:
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-2555
Mailing Address - Country:US
Mailing Address - Phone:410-252-4182
Mailing Address - Fax:
Practice Address - Street 1:408 FOX CHAPEL DR
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-2825
Practice Address - Country:US
Practice Address - Phone:443-928-0172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD162272251G0304X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD16227OtherLICENSE