Healthcare Provider Details

I. General information

NPI: 1710590690
Provider Name (Legal Business Name): MUSILI LATEEF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2020
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15228 MARLBORO PIKE
UPPER MARLBORO MD
20772-3132
US

IV. Provider business mailing address

15228 MARLBORO PIKE
UPPER MARLBORO MD
20772-3132
US

V. Phone/Fax

Practice location:
  • Phone: 202-221-0637
  • Fax:
Mailing address:
  • Phone: 202-221-0637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200001481
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberA00175426
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: