Jason Leondas Brumfield, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Crisfield, MD

NPI 1043831019 · NPPES record last updated May 1, 2020

Key facts

NPI
1043831019
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
A02365 (MD)
Practice address
201 Hall Hwy
Crisfield, MD 21817-1237
Phone
(410) 968-1801
NPI assigned
May 1, 2020
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
A02365MDMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X A02365 MD Yes

Addresses

Primary practice location

201 Hall Hwy
Crisfield, MD 21817-1237

Mailing address

730 9TH St
Pocomoke City, MD 21851-1618
Phone (443) 783-5063

Other providers in Crisfield, MD

All providers in Crisfield, MD · Occupational Therapy Assistant in Maryland

Sources for this page

Verify at the official NPI Registry.