Provider Demographics
NPI:1194765727
Name:BERENSON, JAMIE ALYSSA (DPT)
Entity type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:ALYSSA
Last Name:BERENSON
Suffix:
Gender:F
Credentials:DPT
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Mailing Address - Street 1:109 STONE POINT DRIVE
Mailing Address - Street 2:APT. 258
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7027
Mailing Address - Country:US
Mailing Address - Phone:410-891-0120
Mailing Address - Fax:410-897-9399
Practice Address - Street 1:116 DEFENSE HWY
Practice Address - Street 2:SUITE 101
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7027
Practice Address - Country:US
Practice Address - Phone:410-897-0120
Practice Address - Fax:410-897-9399
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2012-10-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MD215702251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic