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:
Health care specialties
Specialty | Code | License # | 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 last year |
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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1972599819 | NPPES |
Maryland | MEDICAID | 075353000 | |
Maryland | Other | 293466 | |
Maryland | Other | 6545-0007 |
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