Healthcare Provider Details

I. General information

NPI: 1053886333
Provider Name (Legal Business Name): NGALU HAROUN BUZOHERA HOME HEALTH AIDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2018
Last Update Date: 10/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 DECEMBER DR APT 303
SILVER SPRING MD
20904-3615
US

IV. Provider business mailing address

1510 DECEMBER DR APT 303
SILVER SPRING MD
20904-3615
US

V. Phone/Fax

Practice location:
  • Phone: 240-330-0169
  • Fax:
Mailing address:
  • Phone: 240-330-0169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA10424
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: