Provider Demographics
NPI:1386615219
Name:SALISBURY PHYSICAL THERAPY & SPORTSMEDICINE
Entity type:Organization
Organization Name:SALISBURY PHYSICAL THERAPY & SPORTSMEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:BARTOSHESKY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:410-543-9000
Mailing Address - Street 1:949 MOUNT HERMON RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-5105
Mailing Address - Country:US
Mailing Address - Phone:410-543-9000
Mailing Address - Fax:410-543-9033
Practice Address - Street 1:949 MOUNT HERMON RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-5105
Practice Address - Country:US
Practice Address - Phone:410-543-9000
Practice Address - Fax:410-543-9033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-30
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD158882251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS402OtherFEDERAL BCBS
MD211337OtherMAMSI/ALLIANCE
MD071378301Medicaid
MD328AOtherCAREFIRST
MD211337OtherMAMSI/ALLIANCE