Healthcare Provider Details

I. General information

NPI: 1194537365
Provider Name (Legal Business Name): ABDUL AZIZ KAMARA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2025
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 PENNSYLVANIA AVE SE STE 210
WASHINGTON DC
20003-4344
US

IV. Provider business mailing address

6704 CHERRYFIELD RD
FORT WASHINGTON MD
20744-1508
US

V. Phone/Fax

Practice location:
  • Phone: 202-282-3004
  • Fax:
Mailing address:
  • Phone: 703-665-8050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number1401220171
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: