Healthcare Provider Details

I. General information

NPI: 1861732380
Provider Name (Legal Business Name): HENRY OKOGI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2013
Last Update Date: 02/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 BRINKLEY RD APT. 604
FORT WASHINGTON MD
20744-1923
US

IV. Provider business mailing address

2600 BRINKLEY RD APT. 604
FORT WASHINGTON MD
20744-1923
US

V. Phone/Fax

Practice location:
  • Phone: 240-478-5552
  • Fax:
Mailing address:
  • Phone: 240-478-5552
  • 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: