Healthcare Provider Details

I. General information

NPI: 1871381772
Provider Name (Legal Business Name): MARYAM SARKI BABALLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2025
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2512 24TH ST NE
WASHINGTON DC
20018-2126
US

IV. Provider business mailing address

9905 GOOD LUCK RD APT 203
LANHAM MD
20706-3246
US

V. Phone/Fax

Practice location:
  • Phone: 202-832-8340
  • Fax:
Mailing address:
  • Phone: 412-726-4843
  • Fax: 412-726-4843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberR243297
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN1059903
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: