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Organization
MARYLAND INSTITUTE FOR NEUROSCIENCE AND DEVELOPMENT
Active
Organization
MARYLAND INSTITUTE FOR NEUROSCIENCE AND DEVELOPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GONZALO LAJE MD (PRESIDENT)
(301) 576-6044
Entity
Organization
Contact information
Practice address
5480 WISCONSIN AVE, #228, CHEVY CHASE, MD 20815-3530
(301) 576-6044
(301) 576-1645
Mailing address
5480 WISCONSIN AVE, #228, CHEVY CHASE, MD 20815-3530
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
D62330
MD
Other
Enumeration date
11/09/2012
Last updated
11/09/2012
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