Healthcare Provider Details

I. General information

NPI: 1568980233
Provider Name (Legal Business Name): ZENAS TEKUM NJOKOM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2017
Last Update Date: 09/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3572 DEAN DR APT U6
HYATTSVILLE MD
20782-1220
US

IV. Provider business mailing address

3572 DEAN DR APT U6
HYATTSVILLE MD
20782-1220
US

V. Phone/Fax

Practice location:
  • Phone: 202-677-2535
  • Fax: 202-677-2535
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA13018
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: