Individual
MRS. JACALYN GORDON GINSBERG
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
844 RITCHIE HWY, SUITE 206, SEVERNA PARK, MD 21176
(410) 647-8306
(410) 315-8444
Mailing address
844 RITCHIE HWY, SUITE 206, SEVERNA PARK, MD 21176
(410) 647-8306
(410) 315-8444
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
H51249
MD
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
H51249
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08795
PHN
—
01
—
11120
BS POS
—
01
—
H51249
MD LICENSE #
—
01
—
OH64
BS
—
01
—
T5930002
BLUE CHOICE
—
Enumeration date
02/03/2006
Last updated
09/11/2025
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