Healthcare Provider Details

I. General information

NPI: 1285988600
Provider Name (Legal Business Name): MISS NDAH NJOHJAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2012
Last Update Date: 03/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6475 NEW HAMPSHIRE AVE STE 504F
HYATTSVILLE MD
20783-3277
US

IV. Provider business mailing address

6841C RIVERDALE RD APT 201C
RIVERDALE MD
20737-3667
US

V. Phone/Fax

Practice location:
  • Phone: 301-560-1352
  • Fax:
Mailing address:
  • Phone: 347-552-7888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA4735
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: