Healthcare Provider Details

I. General information

NPI: 1164242525
Provider Name (Legal Business Name): ROMAN AMEDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2024
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 UPSHUR ST NW
WASHINGTON DC
20011-5837
US

IV. Provider business mailing address

12741 TURQUOISE TER
SILVER SPRING MD
20904-5348
US

V. Phone/Fax

Practice location:
  • Phone: 202-723-0304
  • Fax:
Mailing address:
  • Phone: 201-850-2494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200004045
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: