Most Relevant Information
Provider Data
| NPI Number: | 1003222704 |
| Provider Name: | JEROME DEPETRIS |
| Entity Type: | Individual |
| Taxonomy Code: | 251E00000X |
| Specialty: | Home Health |
| License Number: | R2580 |
Most Important Dates
| Enumeration Date: | 07/02/2014 |
| Last Updated: | 07/02/2014 |
Provider Practice Location
8601 LASALLE RD
100
TOWSON
MD
212862005
Practice Location Phone/Fax
| Phone: | 4103378910 |
| Fax: | 4103378327 |
Provider Mailing Location
8601 LASALLE ROAD
SUITE 100
TOWSON
MD
212862005
Provider Mailing Phone/Fax
| Phone: | 4103378910 |
| Fax: | 4103378327 |