Basic Information
| Provider Information | |||||||||
| NPI: | 1578687273 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TERLIZZI | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | M. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10513 KEYSER POINT RD | ||||||||
| Address2: | |||||||||
| City: | OCEAN CITY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218429604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102137453 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9730 HEALTHWAY DR | ||||||||
| Address2: | BERLIN HEALTH CENTER | ||||||||
| City: | BERLIN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218111154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4106290164 | ||||||||
| FaxNumber: | 4106290185 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.