MEDICARE: FARIDAH NAKKAZI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	HCSA-00720	MD

General Provider Information

NPI Number	:	1073346664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FARIDAH NAKKAZI

Provider Business Mailing Address
First Line	:	14928 HYDRUS RD
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20906-1828
Country	:	US
Telephone Number	:	202-903-4481
Fax Number	:

Provider Business Practice Location Address
First Line	:	2924 BEL PRE RD APT 101
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20906-2404
Country	:	US
Telephone Number	:	202-578-4736
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2024
Last Update Date	:	08/21/2024

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