Provider Demographics
NPI:1396751152
Name:YESILONIS, ALBION J (MPT)
Entity type:Individual
Prefix:
First Name:ALBION
Middle Name:J
Last Name:YESILONIS
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4058
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-4058
Mailing Address - Country:US
Mailing Address - Phone:301-262-5852
Mailing Address - Fax:301-262-3173
Practice Address - Street 1:9475 DEERECO RD STE 102
Practice Address - Street 2:
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-2124
Practice Address - Country:US
Practice Address - Phone:410-308-3543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19682225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD160200Medicare PIN
MH216512Medicare ID - Type UnspecifiedPROVIDER NUMBER