Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 02426 | MD |
N | 2251E1200X | Ergonomics | 02426 | MD |
N | 225XE1200X | Ergonomics | 02426 | MD |
N | 2251H1300X | Human Factors | 02426 | MD |
N | 225XH1300X | Human Factors | 02426 | MD |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 02426 | MD |
N | 225XP0200X | Occupational Therapist - Pediatrics | 02426 | MD |
NPI | 1720101546 |
---|---|
Provider Name | Ms. Sondra Shoshana Shamberg |
First Address | Baltimore, MD 21215-3718 |
Second Address | Baltimore, MD 21215-3718 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2007 |
Last Update Date | 17/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
521749043 | DORS (01) | MD |
647758500 | (05) | MD |
J776 | BCBS (01) | MD |