| Life Skills/rockville | |
|
9318 Gaither Rd Ste 220 Gaithersburg MD 20877-1407 | |
| (240) 251-4702 | |
| (301) 251-4703 |
| Full Name | Life Skills/rockville |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 9318 Gaither Rd Ste 220, Gaithersburg, Maryland |
| Authorized Official Name and Position | Barton Paul Azwalinsky (CEO) |
| Authorized Official Contact | 3012514702 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Skills/rockville 9318 Gaither Rd Ste 220 Gaithersburg MD 20877-1407 Ph: (240) 251-4702 | Life Skills/rockville 9318 Gaither Rd Ste 220 Gaithersburg MD 20877-1407 Ph: (240) 251-4702 |
| NPI Number | 1114236692 |
|---|---|
| Provider Enumeration Date | 09/30/2010 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 9133108293 |
|---|---|
| Medicare Enrollment ID | O20040714000588 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114236692 | NPI | - | NPPES |
| Provider Name | Simona Pick Both |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043246614 PECOS PAC ID: 7214982941 Enrollment ID: I20050316000121 |
| Provider Name | Khaled A Khalafallah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295752061 PECOS PAC ID: 3476644725 Enrollment ID: I20070801000365 |
| Provider Name | Shobha L Solomon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447447974 PECOS PAC ID: 6709966260 Enrollment ID: I20080227000855 |
| Provider Name | Jae Hoon Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760726525 PECOS PAC ID: 6901042993 Enrollment ID: I20160504001462 |
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