Healthcare Provider Details

I. General information

NPI: 1871935981
Provider Name (Legal Business Name): JULIANA AFI AYIVOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2013
Last Update Date: 03/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 FORBES BLVD
LANHAM MD
20706-6103
US

IV. Provider business mailing address

1818 NEW YORK AVE NE
WASHINGTON DC
20002-1848
US

V. Phone/Fax

Practice location:
  • Phone: 301-577-1381
  • Fax:
Mailing address:
  • Phone: 301-693-4209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberHHA8139
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: