Healthcare Provider Details

I. General information

NPI: 1316664113
Provider Name (Legal Business Name): ERIC M NDI HOME HEALTH AIDE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ERIC M DNI

II. Dates (important events)

Enumeration Date: 10/21/2022
Last Update Date: 05/13/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7751 RIVERDALE RD APT 103
NEW CARROLLTON MD
20784-3916
US

IV. Provider business mailing address

3504 COMMODORE JOSHUA BARNEY APT 301
DISTRICT OF COLUMBIA DC
20784-3916
US

V. Phone/Fax

Practice location:
  • Phone: 301-723-1016
  • Fax:
Mailing address:
  • Phone: 130-172-3101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200002229
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: