Supportive Care of Maryland LLC

NPI #1447802616 in Riverdale, Maryland

Provider Information

NPI Number: 1447802616
Entity Type: Organization
Organization Name: Supportive Care of Maryland LLC
Primary Specialty: Psychologist
Enumeration Date: Jul 9, 2019
Last Updated: Jul 9, 2019

Practice Location

Address: 4409 E WEST HWY
City: Riverdale
State: Maryland
ZIP Code: 20737-1058
Phone: (718) 298-4375

Authorized Official

Name: RAPHAEL LICHTSCHEIN
Title: OWNERR
Phone: (718) 506-1115

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist	103T00000X	Primary

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