Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 2305214847 | VA |
N | 225100000X | Physical Therapist | PT010119L | PA |
N | 2251S0007X | Physical Therapist - Sports | PT010119L | PA |
N | 2251X0800X | Physical Therapist - Orthopedic | PT010119L | PA |
NPI | 1073508677 |
---|---|
Provider Name | Matthew D Babbitt |
First Address | Baltimore, MD 21297-3174 |
Second Address | Chantilly, VA 20152-4113 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2005 |
Last Update Date | 11/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0052130 | ORTHONET (01) | PA |
02168901 | BLUE CROSS (01) | PA |
02168901 | KEYSTONE CENTRAL (01) | |
7703097 | AETNA (01) | PA |
869617 | BLUE SHIELD (01) | PA |
869617 | FIRST PRIORITY LIFE (01) | PA |
896917 | PERSONAL CHOICE (01) | PA |