NPI 1003222704

Jerome Depetris

Practitioner Home Health Agency Towson, MD

Practice location

Address: 8601 Lasalle Rd 100, Towson, MD 21286-2005
Phone: (410) 337-8910
Fax: (410) 337-8327
Mailing address: 8601 Lasalle Road Suite 100, Towson, MD 21286-2005

Registered specialties

Home Health Agency Primary

Agencies Taxonomy 251E00000X Licence R2580 (MD)

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Registry record

NPI: 1003222704
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 Jul 2014
Record last updated: 2 Jul 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.