Healthcare Provider Details

I. General information

NPI: 1508621269
Provider Name (Legal Business Name): NGOZIKA ANYIAM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2024
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5802 ANNAPOLIS RD APT 202
BLADENSBURG MD
20710-2015
US

IV. Provider business mailing address

5802 ANNAPOLIS RD APT 202
BLADENSBURG MD
20710-2015
US

V. Phone/Fax

Practice location:
  • Phone: 347-282-8010
  • Fax:
Mailing address:
  • Phone: 347-282-8010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200002639
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: