Herdson, Jay

Herdson, Jay is an individual health care provider with primary practice located at 6011 University Blvd Suite 120, Ellicott City MD 21043-6074. He recently has 3 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Sports, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is his primary health care specialty. Herdson, Jay can be contacted via phone (410) 203-0391.

Contact Information

Primary practice address
6011 University Blvd Suite 120 Ellicott City MD 21043-6074
Phone: (410) 203-0391
Fax: (410) 203-2707
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Sports 2251S0007X 19964 Maryland
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic 2251X0800X 19964 Maryland
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 19964 Maryland

Profile Details

NPI number 1972599819
LBN Legal business name Herdson, Jay
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2005
Last updated Jan 18th, 2024 - about 8 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972599819 NPPES
Maryland MEDICAID 075353000
Maryland Other 293466
Maryland Other 6545-0007

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