MEDICARE: ABDUL CEESAY DOZA CRNP-PMH

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	R226469	MD

General Provider Information

NPI Number	:	1922796416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABDUL CEESAY DOZA CRNP-PMH

Provider Business Mailing Address
First Line	:	8000 JUMPERS HOLE RD STE 221
Second Line	:
City	:	PASADENA
State	:	MD
Zip	:	21122-1036
Country	:	US
Telephone Number	:	301-699-1411
Fax Number	:	443-577-4110

Provider Business Practice Location Address
First Line	:	8000 JUMPERS HOLE RD STE 221
Second Line	:
City	:	PASADENA
State	:	MD
Zip	:	21122-1036
Country	:	US
Telephone Number	:	301-699-1411
Fax Number	:	443-577-4110

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

Provider Enumeration Date	:	04/24/2023
Last Update Date	:	01/27/2026

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