NPIMap

Organization Active NPI

Maryland Physical Therapy and Wellness Center

  • Physical Therapist
  • Laurel, MD
National Provider Identifier
1629334644
Registry record updated Apr 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20615 Issued in MD
Legal business name
MARYLAND PHYSICAL THERAPY AND WELLNESS CENTER
Practice address
7350 Van Dusen Rd
Suite 110
Laurel, MD 20707-5263
Phone
(410) 913-5933
NPI assigned
Apr 3, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2012

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

Authorized official

Name
Marina Kachuriner, DPT
Title
Owner
Phone
(410) 913-5933

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 20615 MD Primary

Addresses

Primary practice location

7350 Van Dusen Rd
Suite 110
Laurel, MD 20707-5263

Mailing address

4982 Dorsey Hall Dr
Unit C5
Ellicott City, MD 21042-7775

National Provider Directory

National Provider Directory

Locations

7350 Van Dusen Rd
Ste 420
Laurel, MD 20707
Phone (301) 490-4055

NPI Registry JSON

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333411200000",
    "number": "1629334644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4982 DORSEY HALL DR",
            "address_2": "UNIT C5",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7350 VAN DUSEN RD",
            "address_2": "SUITE 110",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075263",
            "telephone_number": "410-913-5933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND PHYSICAL THERAPY AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-03",
        "last_updated": "2012-04-03",
        "status": "A",
        "authorized_official_last_name": "KACHURINER",
        "authorized_official_first_name": "MARINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-913-5933",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "20615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.