Maryland Institute for Neuroscience and Development

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

D62330 Issued in MD

Legal business name

MARYLAND INSTITUTE FOR NEUROSCIENCE AND DEVELOPMENT

Practice address

5480 Wisconsin Ave
#228
Chevy Chase, MD 20815-3530

Phone

(301) 576-6044

Fax

(301) 576-1645

NPI assigned

Nov 9, 2012

Organization subpart

No

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

Authorized official

Name

Gonzalo Laje, MDNPI 1750501516

Title

President

Phone

(301) 576-6044

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gonzalo Laje, MD

  • Psychiatry Physician
  • Chevy Chase, MD
  • NPI 1750501516

  Child & Adolescent Psychiatry

  NPD (past) Authorized official

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

{
    "created_epoch": "1352419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352419200000",
    "number": "1295089480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5480 WISCONSIN AVE",
            "address_2": "#228",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208153530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5480 WISCONSIN AVE",
            "address_2": "#228",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208153530",
            "telephone_number": "301-576-6044",
            "fax_number": "301-576-1645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND INSTITUTE FOR NEUROSCIENCE AND DEVELOPMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-09",
        "last_updated": "2012-11-09",
        "status": "A",
        "authorized_official_last_name": "LAJE",
        "authorized_official_first_name": "GONZALO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-576-6044",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MD",
            "license": "D62330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily L Martinson, AU.D., PH.D.
• Mary C Dupont MD PC
• Mary K. Craddock MD PC
• Maryland Center for Evidence Based Therapy LLC
• Maryland CVS Pharmacy, L.L.C.
• Maryland Luna Care Physical Therapy LLC
• Maryland Oncology Hematology, PA
• Maryland Physicians Edge LLC
• John Mastropaolo, PH.D.
• Marvin Mathews

• All providers in Chevy Chase, MD
• Child & Adolescent Psychiatry Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; 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.