Provider Demographics
NPI:1750963690
Name:MARYLAND CENTER FOR ARTHRITIS AND REGENERATIVE CARE LLC
Entity type:Organization
Organization Name:MARYLAND CENTER FOR ARTHRITIS AND REGENERATIVE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:HOROWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-650-9804
Mailing Address - Street 1:300 FREDERICK RD STE 102
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4682
Mailing Address - Country:US
Mailing Address - Phone:410-650-9804
Mailing Address - Fax:410-630-5546
Practice Address - Street 1:300 FREDERICK RD STE 102
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4682
Practice Address - Country:US
Practice Address - Phone:215-850-2474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-21
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty