MEDICARE: RACHELE KAMWA SADJO

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	374U00000X	Home Health Aide		DC

General Provider Information

NPI Number	:	1457917445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHELE KAMWA SADJO

Provider Business Mailing Address
First Line	:	2129 ROLANDER ST
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20783-2158
Country	:	US
Telephone Number	:	202-779-7098
Fax Number	:

Provider Business Practice Location Address
First Line	:	2129 ROLANDER ST
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20783-2158
Country	:	US
Telephone Number	:	202-779-7098
Fax Number	:

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

Provider Enumeration Date	:	05/15/2019
Last Update Date	:	05/15/2019

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Directions to “ RACHELE KAMWA SADJO ” Practice Location

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