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Organization
PLAZA REHABILITATION, LLC
Active
Organization
PLAZA REHABILITATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD J LYONS PT (OWNER)
(410) 795-7696
Entity
Organization
Contact information
Practice address
1912 LIBERTY RD, SYKESVILLE, MD 21784-6602
(410) 795-7696
(410) 795-5789
Mailing address
1912 LIBERTY RD, SYKESVILLE, MD 21784-6602
(410) 795-7696
(410) 795-5789
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17195
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2126696
MAMSI
MD
01
—
3584115
UNITED HEALTHCARE
MD
01
—
3584226
AETNA
MD
01
—
7295156
AETNA
MD
01
—
962APL
CAREFIRST MARYLAND
MD
01
—
T473
GHMSI
MD
Enumeration date
11/29/2006
Last updated
08/22/2020
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