Healthcare Provider Details

I. General information

NPI: 1093552226
Provider Name (Legal Business Name): ZUMEKO REHABILITATIVE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2024
Last Update Date: 07/15/2024
Certification Date: 07/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4018 36TH ST
MOUNT RAINIER MD
20712-1912
US

IV. Provider business mailing address

4018 36TH ST
MOUNT RAINIER MD
20712-1912
US

V. Phone/Fax

Practice location:
  • Phone: 202-664-0026
  • Fax: 301-864-0341
Mailing address:
  • Phone: 202-664-0026
  • Fax: 301-864-0341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR RICKY ENWERE SR.
Title or Position: CEO
Credential:
Phone: 202-664-0026