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Organization
SHADY GROVE SNF LLC
Active
Organization
SHADY GROVE SNF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISRAEL BIRNBAUM (AUTHORIZED OFFICIAL)
(917) 685-8278
Entity
Organization
Contact information
Practice address
9701 MEDICAL CENTER DR, ROCKVILLE, MD 20850-3326
(301) 315-1900
Mailing address
9701 MEDICAL CENTER DR, ROCKVILLE, MD 20850-3326
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
11/01/2018
Last updated
11/01/2018
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