Healthcare Provider Details

I. General information

NPI: 1518684406
Provider Name (Legal Business Name): STANLEY OKORIE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2022
Last Update Date: 10/21/2022
Certification Date: 10/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5101 SARGENT RD NE APT 101
WASHINGTON DC
20017-2825
US

IV. Provider business mailing address

5101 SARGENT RD NE APT 101
WASHINGTON DC
20017-2825
US

V. Phone/Fax

Practice location:
  • Phone: 202-544-8090
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: