Jay Bradford Clark in Baltimore - Geriatrics

Jay Bradford Clark - NPI 1235255837

Jay Bradford Clark is a Geriatrics in Baltimore, Maryland. Jay Bradford Clark practices all healthcare services and medical treatments related to Geriatrics. The NPI Number for Jay Bradford Clark is 1235255837. The last update date is 2009-07-17.

Jay Bradford Clark's current location address is 4807 Benson Ave., Baltimore, Maryland. You can contact this provider via phone number 4102428963 and fax number 4102428965. The mailing address for Jay Bradford Clark is 4807 Benson Ave., Baltimore, Maryland. To know further, please read the information below!

Provider Profile Detail

Provider Name Jay Bradford Clark
Address 4807 Benson Ave., Baltimore, Maryland
Phone Number 4102428963
Fax Number 4102428965
Sole Proprietor Y
Credentials DSCPT, MPT

NPI Number Detail

NPI Number 1235255837
Provider Enumeration Date 2007-03-22
Last Updated Date 2009-07-17

Provider Mailing Address Detail

Address 4807 Benson Ave.
City Baltimore
State Maryland (MD)
Post Code 212271530
Phone Number 4102428963
Fax Number 4102428965

Provider's Primary Taxonomy Detail

Speciality Geriatrics
Taxonomy 2251G0304X
Licence No 18491
Definition:
A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Geriatric Physical Therapy, who has demonstrated specialized knowledge and skill in the comprehensive biopsychosocial assessment and evid

Provider's Other Legacy Identifiers

Identifier Identifier Type Identifier State Identifier Issuer
20880900 MD --

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FAQs about Jay Bradford Clark

What is the unique 10-digit identifier code issued to Jay Bradford Clark by the Centers for Medicare & Medicaid Services?

The Jay Bradford Clark has been assigned the NPI (National Provider Identifier) 1235255837 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.

Could you kindly provide the complete physical address where Jay Bradford Clark's facilities are geographically located?

The facilities of Jay Bradford Clark are physically situated at the following location: 4807 Benson Ave., Baltimore, MD, 212271530.

What is the Jay Bradford Clark's specialty and taxonomy code?

The Jay Bradford Clark's specialty is Geriatrics, and the corresponding taxonomy code is 2251G0304X.

On what date did the Centers for Medicare & Medicaid Services assign the 1235255837 to Jay Bradford Clark?

The Centers for Medicare & Medicaid Services assigned the 1235255837 to Jay Bradford Clark on 2007-03-22.

When was the Jay Bradford Clark's information last updated?

The Jay Bradford Clark's information was last updated on 2009-07-17.

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