Individual
JASON BENINCASA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
707 N BROADWAY, BALTIMORE, MD 21205-1832
(443) 923-9289
(443) 923-9295
Mailing address
707 N BROADWAY, BALTIMORE, MD 21205-1832
(443) 923-9289
(443) 923-9295
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
24412
MD
2251P0200X
Pediatric Physical Therapist
PT 020542
PA
Other
Enumeration date
06/01/2010
Last updated
03/20/2013
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