Provider Demographics
NPI:1336811678
Name:RAJASEKARAN, JULIE
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:RAJASEKARAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7126 NATURES RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-1606
Mailing Address - Country:US
Mailing Address - Phone:240-447-6522
Mailing Address - Fax:
Practice Address - Street 1:10750 RHODE ISLAND AVE
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-2513
Practice Address - Country:US
Practice Address - Phone:301-937-1632
Practice Address - Fax:301-576-7257
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28150225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist