Provider Demographics
NPI:1912347543
Name:BELLINGER, ELIZABETH CAVANAUGH (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:CAVANAUGH
Last Name:BELLINGER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:R
Other - Last Name:CAVANAUGH-BROAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT,DPT
Mailing Address - Street 1:2502 KEN OAK RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-4110
Mailing Address - Country:US
Mailing Address - Phone:412-512-9302
Mailing Address - Fax:
Practice Address - Street 1:3600 CLIPPER MILL RD STE 115
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-1957
Practice Address - Country:US
Practice Address - Phone:443-961-4546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD245212251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD24521OtherLINCENSE