Healthcare Provider Details

I. General information

NPI: 1922434752
Provider Name (Legal Business Name): HAJI Z SACCOH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2013
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12308 FOYETTE LN
UPPER MARLBORO MD
20772-9308
US

IV. Provider business mailing address

5804 ANNAPOLIS RD
BLADENSBURG MD
20710-2076
US

V. Phone/Fax

Practice location:
  • Phone: 301-674-7467
  • Fax:
Mailing address:
  • Phone:
  • 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 Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: