Provider Demographics
NPI:1487757498
Name:BLUMENSCHEIN, TANJA (PT)
Entity type:Individual
Prefix:
First Name:TANJA
Middle Name:
Last Name:BLUMENSCHEIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-3335
Mailing Address - Country:US
Mailing Address - Phone:847-924-9068
Mailing Address - Fax:
Practice Address - Street 1:10731 SAINT MARGARETS WAY
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2831
Practice Address - Country:US
Practice Address - Phone:847-924-9068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070014137225100000X
MD25537225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist