MEDICARE: ROSINE FOUODJI

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	3747P1801X	Personal Care Attendant
2	374U00000X	Home Health Aide	HHA15354	DC

General Provider Information

NPI Number	:	1285198085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSINE FOUODJI

Provider Business Mailing Address
First Line	:	9102 7TH ST
Second Line	:
City	:	LANHAM
State	:	MD
Zip	:	20706-2745
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9102 7TH ST
Second Line	:
City	:	LANHAM
State	:	MD
Zip	:	20706-2745
Country	:	US
Telephone Number	:	301-318-4775
Fax Number	:

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

Provider Enumeration Date	:	01/25/2019
Last Update Date	:	06/03/2021

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Directions to “ ROSINE FOUODJI ” Practice Location

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