Healthcare Provider Details

I. General information

NPI: 1366703209
Provider Name (Legal Business Name): TRUST NDUKWU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2012
Last Update Date: 03/25/2024
Certification Date: 03/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6514 GREENFIELD CT
LANHAM MD
20706-3556
US

IV. Provider business mailing address

7826 EASTERN AVE NW LL18A
WASHINGTON DC
20012-1324
US

V. Phone/Fax

Practice location:
  • Phone: 202-509-1550
  • Fax:
Mailing address:
  • Phone: 202-722-7776
  • Fax: 202-722-7785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: