Healthcare Provider Details

I. General information

NPI: 1447951355
Provider Name (Legal Business Name): SSENGENDO KIGOZI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2023
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4017 MINNESOTA AVE NE
WASHINGTON DC
20019-3541
US

IV. Provider business mailing address

7651 MANDRAKE CT UNIT 310
ELKRIDGE MD
21075-7985
US

V. Phone/Fax

Practice location:
  • Phone: 202-388-9202
  • Fax:
Mailing address:
  • Phone: 617-943-3288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: