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Organization
SPECIALTY PAIN MANAGEMENT SERVICES
Active
Organization
SPECIALTY PAIN MANAGEMENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LYDIA BONGIORNI OTR/L (OCCUPATIONAL THERAPIST)
(443) 472-2449
Entity
Organization
Contact information
Practice address
8008 NIGHTWIND CT, ELKRIDGE, MD 21075-6463
(410) 404-6071
Mailing address
8008 NIGHTWIND CT, ELKRIDGE, MD 21075-6463
(410) 404-6071
Taxonomy
Speciality
Code
Description
License number
State
225XN1300X
Neurorehabilitation Occupational Therapist
—
NULL
225XN1300X
Neurorehabilitation Occupational Therapist
—
—
225XP0019X
Physical Rehabilitation Occupational Therapist
—
NULL
225XP0019X
Physical Rehabilitation Occupational Therapist
—
—
261QR0400X
Rehabilitation Clinic/Center
Primary
—
NULL
Other
Enumeration date
06/18/2021
Last updated
03/08/2023
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