Healthcare Provider Details

I. General information

NPI: 1477480572
Provider Name (Legal Business Name): JACQUES DEUMENY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 JOYCETON WAY
UPPER MARLBORO MD
20774-1327
US

IV. Provider business mailing address

42 JOYCETON WAY
UPPER MARLBORO MD
20774-1327
US

V. Phone/Fax

Practice location:
  • Phone: 202-660-2384
  • Fax:
Mailing address:
  • Phone: 202-660-2384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200006362
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: