Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 15514 | MD |
N | 2251G0304X | Physical Therapist - Geriatrics | 15514 | MD |
N | 2251P0200X | Physical Therapist - Pediatrics | ||
Y | 2251X0800X | Physical Therapist - Orthopedic |
NPI | 1326327677 |
---|---|
Provider Name | Marlyn Cohen Safren |
First Address | Ellicott City, MD 21042-1436 |
Second Address | Ellicott City, MD 21042 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2011 |
Last Update Date | 04/08/2011 |