Healthcare Provider Details

I. General information

NPI: 1598020919
Provider Name (Legal Business Name): CYNTHIA OBIWURU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

9124 MCHENRY LANE
LANHAM MD
20706
US

IV. Provider business mailing address

9124 MCHENRY LANE
LANHAM MD
20706
US

V. Phone/Fax

Practice location:
  • Phone: 301-814-9522
  • Fax:
Mailing address:
  • Phone: 301-814-9522
  • 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: