MEDICARE: SIRRIA MAFOR CHO MAMA

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

General Provider Information

NPI Number	:	1467831644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIRRIA MAFOR CHO MAMA

Provider Business Mailing Address
First Line	:	3499 FORT MEADE RD
Second Line	:	APT 2
City	:	LAUREL
State	:	MD
Zip	:	20724-2063
Country	:	US
Telephone Number	:	202-378-7625
Fax Number	:

Provider Business Practice Location Address
First Line	:	3499 FORT MEADE RD
Second Line	:	APT 2
City	:	LAUREL
State	:	MD
Zip	:	20724-2063
Country	:	US
Telephone Number	:	202-378-7625
Fax Number	:

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

Provider Enumeration Date	:	05/21/2015
Last Update Date	:	05/21/2015

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Directions to “ SIRRIA MAFOR CHO MAMA ” Practice Location

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