Healthcare Provider Details

I. General information

NPI: 1821820002
Provider Name (Legal Business Name): AARON EYOB
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2024
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4231 CLAY ST NE
WASHINGTON DC
20019-3435
US

IV. Provider business mailing address

4231 CLAY ST NE
WASHINGTON DC
20019-3435
US

V. Phone/Fax

Practice location:
  • Phone: 484-264-5198
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: