Provider Demographics
NPI:1144304965
Name:ALBORES-HARRIS, MARIA CECILIA (PT)
Entity type:Individual
Prefix:
First Name:MARIA CECILIA
Middle Name:
Last Name:ALBORES-HARRIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARIA CECILIA
Other - Middle Name:A
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:866-370-8206
Mailing Address - Fax:517-435-3670
Practice Address - Street 1:580 RITCHIE HWY
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-3924
Practice Address - Country:US
Practice Address - Phone:443-261-2243
Practice Address - Fax:410-384-1617
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18195225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD149202100Medicaid
MDJ3600004OtherBCBS FEP PROVIDER NO.
MD63978901OtherBCBS COMMERCIAL PROVIDER
MD729LH568Medicare ID - Type UnspecifiedMEDICARE PROVIDER NO.