Healthcare Provider Details

I. General information

NPI: 1235042706
Provider Name (Legal Business Name): CHARLES NJI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 GEORGIA AVE NW STE 323
WASHINGTON DC
20012-1616
US

IV. Provider business mailing address

4705 TECUMSEH ST
COLLEGE PARK MD
20740-2114
US

V. Phone/Fax

Practice location:
  • Phone: 202-723-3060
  • Fax:
Mailing address:
  • Phone: 240-492-8647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN7461
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: