Provider Demographics
NPI:1023024155
Name:REICHERTER, ELIZABETH ANNE (DPT)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANNE
Last Name:REICHERTER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:ELIZABETH
Other - Middle Name:ANNE
Other - Last Name:RURA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2448 HOLLY AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3148
Mailing Address - Country:US
Mailing Address - Phone:410-295-4941
Mailing Address - Fax:410-295-5207
Practice Address - Street 1:2448 HOLLY AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3148
Practice Address - Country:US
Practice Address - Phone:410-295-4941
Practice Address - Fax:410-295-5207
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19183225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5632510OtherFIRST HEALTH NETWORK
MD756LL516OtherRAILROAD MEDICARE
MD57731OtherJOHN HOPKINS HEALTHCARE
MD5632510OtherCCN NETWORK
MDT6710019OtherBLUECROSS BLUESHIELD DC
MD620676-16OtherBLUECROSS BLUESHIELD MD
MD703242OtherNCPPO
MD2530149OtherUNITED HEALTHCARE
MDQ46168Medicare UPIN
MD2530149OtherUNITED HEALTHCARE