Provider Demographics
NPI:1801103544
Name:MORONEY, PAUL (PT)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:MORONEY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 CROSSROADS DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5420
Mailing Address - Country:US
Mailing Address - Phone:410-998-9133
Mailing Address - Fax:410-338-3155
Practice Address - Street 1:23 CROSSROADS DR
Practice Address - Street 2:SUITE 300
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5420
Practice Address - Country:US
Practice Address - Phone:410-998-9133
Practice Address - Fax:410-338-3155
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20112225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist