Healthcare Provider Details

I. General information

NPI: 1003644568
Provider Name (Legal Business Name): FNU AERIEL AGAH ACHU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2024
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13818 CASTLE BLVD APT 202
SILVER SPRING MD
20904-7340
US

IV. Provider business mailing address

13818 CASTLE BLVD APT 202
SILVER SPRING MD
20904-7340
US

V. Phone/Fax

Practice location:
  • Phone: 240-505-6457
  • Fax:
Mailing address:
  • Phone: 240-505-6457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: