Zandra E. Cephas, ASPT,CPT

Individual provider Active NPI Technician/Technologist · Fruitland, MD

NPI 1780100735 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1780100735
Entity type
Individual (NPI type 1)
Primary specialty
Technician/Technologist 156F00000X
License
681104140001 (MD)
Practice address
202 Holly St
Fruitland, MD 21826-2005
Phone
(410) 726-6573
Fax
(410) 831-3548
NPI assigned
Aug 21, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
681104140001MDMDTechnician/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wings of Life Mobile LLC Current
since Jul 24, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Technician/Technologist 156F00000X 681104140001 MD Yes

Addresses

Primary practice location

202 Holly St
Fruitland, MD 21826-2005

Mailing address

202 Holly St
Fruitland, MD 21826-2005
Phone (410) 726-6573

Other providers in Fruitland, MD

All providers in Fruitland, MD · Technician/Technologist in Maryland

Sources for this page

Verify at the official NPI Registry.