Healthcare Provider Details

I. General information

NPI: 1821709148
Provider Name (Legal Business Name): NGOZI A ECHEOZO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2022
Last Update Date: 12/07/2022
Certification Date: 12/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 48TH ST NE # EAST
WASHINGTON DC
20019-3607
US

IV. Provider business mailing address

14119 YORKSHIRE WOODS DR
SILVER SPRING MD
20906-2872
US

V. Phone/Fax

Practice location:
  • Phone: 202-541-9844
  • Fax: 202-541-9845
Mailing address:
  • Phone: 404-749-8452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA14858
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: