Provider Demographics
NPI:1780304659
Name:SVINGOS, ADRIAN (PHD)
Entity type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:
Last Name:SVINGOS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4036
Mailing Address - Country:US
Mailing Address - Phone:302-494-6090
Mailing Address - Fax:
Practice Address - Street 1:716 N BROADWAY # 3-306
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21205-1806
Practice Address - Country:US
Practice Address - Phone:443-923-7947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06654103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist