Individual provider Active NPI

Enoch Samraj

  • Physical Therapist
  • Glen Burnie, MD
National Provider Identifier
1114398575
Registry record updated Oct 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
25699 Issued in MD
Practice address
7310 Ritchie Hwy
Ste 500
Glen Burnie, MD 21061-3065
Phone
(410) 766-4047
Fax
(410) 766-4049
NPI assigned
Oct 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 25699 MD Primary

Addresses

Primary practice location

7310 Ritchie Hwy
Ste 500
Glen Burnie, MD 21061-3065

Mailing address

1028 Rockville Pike
Rockville, MD 20852-1404
Phone (301) 838-4445

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444608000000",
    "number": "1114398575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 ROCKVILLE PIKE",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208521404",
            "telephone_number": "301-838-4445",
            "fax_number": "301-838-1949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7310 RITCHIE HWY",
            "address_2": "STE 500",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613065",
            "telephone_number": "410-766-4047",
            "fax_number": "410-766-4049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMRAJ",
        "first_name": "ENOCH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-12",
        "last_updated": "2015-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "25699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.