MEDICARE: MRS. COLETTE TUMENTA

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
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1902167612
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. COLETTE TUMENTA

Provider Business Mailing Address
First Line	:	1209 RYON WAY
Second Line	:
City	:	DISTRICT HEIGHTS
State	:	MD
Zip	:	20747-1777
Country	:	US
Telephone Number	:	240-302-0975
Fax Number	:

Provider Business Practice Location Address
First Line	:	1209 RYON WAY
Second Line	:
City	:	DISTRICT HEIGHTS
State	:	MD
Zip	:	20747-1777
Country	:	US
Telephone Number	:	240-302-0975
Fax Number	:

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

Provider Enumeration Date	:	05/30/2012
Last Update Date	:	06/13/2023

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Directions to “ MRS. COLETTE TUMENTA ” Practice Location

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