Healthcare Provider Details

I. General information

NPI: 1194103374
Provider Name (Legal Business Name): RYTA NGOGANG ACHIAGEONZOH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2015
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7826 EASTERN AVE NW LL16
WASHINGTON DC
20012-1324
US

IV. Provider business mailing address

7826 EASTERN AVE NW LL16
WASHINGTON DC
20012-1324
US

V. Phone/Fax

Practice location:
  • Phone: 202-723-1100
  • Fax: 202-723-3271
Mailing address:
  • Phone: 202-723-1100
  • Fax: 202-723-3271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: