Healthcare Provider Details

I. General information

NPI: 1336483114
Provider Name (Legal Business Name): OLGA MARIA RYDZ HHA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2012
Last Update Date: 11/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14163 CASTLE BLVD APT 402
SILVER SPRING MD
20904-4785
US

IV. Provider business mailing address

14163 CASTLE BLVD APT 402
SILVER SPRING MD
20904-4785
US

V. Phone/Fax

Practice location:
  • Phone: 202-403-7790
  • Fax:
Mailing address:
  • Phone: 202-403-7790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: