Provider Information for 1083682702
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JEFFREY TUCHMAN LCSW
Sex: Male
NPI: 1083682702
Last Updated: 2019-06-07
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1083682702 | ||||||||
| Enumeration Date | 2006-03-09 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 20 FOREST GLEN CT REISTERSTOWN, MD 21136-1631 United States Phone: 443-386-9604 | Fax: | ||||||||
| Primary Practice Address | 200 E NORTH AVE RELATED SERVICES RM 210 BALTIMORE, MD 21202 United States Phone: 443-642-4211 | Fax: | ||||||||
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