Provider Demographics
NPI:1144678731
Name:QUICK DIAGNOSIS
Entity type:Organization
Organization Name:QUICK DIAGNOSIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:RANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:BERKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:443-660-6712
Mailing Address - Street 1:3502 MENLO DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-3830
Mailing Address - Country:US
Mailing Address - Phone:443-660-6712
Mailing Address - Fax:410-358-5131
Practice Address - Street 1:3502 MENLO DR
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-3830
Practice Address - Country:US
Practice Address - Phone:443-660-6712
Practice Address - Fax:410-358-5131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-25
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR213211363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty