Healthcare Provider Details

I. General information

NPI: 1356924203
Provider Name (Legal Business Name): RACHAEL FALADE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2021
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3405 DODGE PARK RD APT 204
LANDOVER MD
20785-2013
US

IV. Provider business mailing address

3405 DODGE PARK RD APT 204
LANDOVER MD
20785-2013
US

V. Phone/Fax

Practice location:
  • Phone: 240-579-2705
  • Fax:
Mailing address:
  • Phone: 240-579-2705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200003096
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberA00193436
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: