Provider Demographics
NPI:1942234067
Name:KUSERK, LINDA A (DPT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:A
Last Name:KUSERK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15201 SHADY GROVE RD
Mailing Address - Street 2:#106
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850
Mailing Address - Country:US
Mailing Address - Phone:301-948-4395
Mailing Address - Fax:301-840-8972
Practice Address - Street 1:15201 SHADY GROVE RD
Practice Address - Street 2:#106
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850
Practice Address - Country:US
Practice Address - Phone:301-948-4395
Practice Address - Fax:301-840-8972
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16145225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
000N67525Medicare ID - Type Unspecified