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7080 DEEPAGE DR COLUMBIA MD 210455219
JARED GOLDSTEIN is physician registered in the Centers for Medicare & Medicaid Services (CMS). The National Provider Identifier (NPI) of the National Plan and Provider Enumeration System (NPPES) is 1184778474. The unique individual professional ID assigned by Provider Enrollment, Chain, and Ownership System (PECOS) is 9234032665. The primary specialty is PHYSICAL THERAPY. The organization is MARYLAND SPORTSCARE AND REHAB LLC. The address is 7080 DEEPAGE DR, , COLUMBIA, MD, 210455219. The zip code is 210455219.
|Nation Provider ID||1184778474|
|PAC ID by PECOS||9234032665|
|Professional Enrollment ID||I20040131000274|
|Medical School Name||OTHER|
|Primary Specialty||PHYSICAL THERAPY|
|All secondary specialties|
|Organization Name||MARYLAND SPORTSCARE AND REHAB LLC|
|Group Practice PAC ID||2860440427|
|Number of Group Practice members||71|
|Address||7080 DEEPAGE DR, , COLUMBIA, MD, 210455219|
|Hospital affiliation LBN|