OrganizationActive
115 East Melrose Avenue Operations LLC
NPI 1235583600 · Physical Therapist · Baltimore, MD
Provider details
- NPI number
- 1235583600
- Entity type
- Organization
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Michael Berg, Assistant Secretary(505) 468-4752
- License
- 30044 (MD)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
115 E Melrose Ave
Baltimore, MD 21212-2945
Phone: (410) 435-9073
Approximate (ZIP-level) locationGet directions
Mailing address
115 E Melrose Ave
Baltimore, MD 21212-2945
Other names (DBA / former)
- Doing business as
- Long Green Center
Registry dates
- Enumerated
- 2016-04-21
- Last updated
- 2017-09-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.