MEDICARE: ROSELINE DJOUKA

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1255152484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSELINE DJOUKA

Provider Business Mailing Address
First Line	:	11700 OLD COLUMBIA PIKE APT 1015
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-2555
Country	:	US
Telephone Number	:	202-384-0935
Fax Number	:

Provider Business Practice Location Address
First Line	:	11700 OLD COLUMBIA PIKE APT 1015
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-2555
Country	:	US
Telephone Number	:	202-384-0935
Fax Number	:

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

Provider Enumeration Date	:	10/21/2024
Last Update Date	:	10/21/2024

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Directions to “ ROSELINE DJOUKA ” Practice Location

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