Basic Information
| Provider Information | |||||||||
| NPI: | 1164503546 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TOROCKIO | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | ALAN | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7116 TULIP CT | ||||||||
| Address2: | |||||||||
| City: | ELDERSBURG | ||||||||
| State: | MD | ||||||||
| PostalCode: | 217845960 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4432716299 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2470 LONGSTONE LN STE K | ||||||||
| Address2: | |||||||||
| City: | MARRIOTTSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211041515 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104422470 | ||||||||
| FaxNumber: | 4104422476 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2006 | ||||||||
| LastUpdateDate: | 04/20/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251X0800X | 17480 | MD | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic | 225100000X | 17480 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 2251S0007X | 17480 | MD | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Sports |
No ID Information.