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General NPI Number Information
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NPI Number | 1265972533
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Entity Type | Individual
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Provider Name | GEREMIAS LUZON CNA
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Gender | Male
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Dates
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Enumeration Date | 03/06/2017
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Last Update Date | 03/06/2017
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Provider Practice Location Address
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Address Line | 1731 BUNKER HILL RD NE
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City | WASHINGTON
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State | DC
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Zip | 20017-3026
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Country | US
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Telephone | 202-635-5756
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Fax | 202-635-5780
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Provider Business Mailing Address
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Address Line | 3404 NICHOLSON ST
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City | HYATTSVILLE
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State | MD
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Zip | 20782-3172
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Country | US
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Telephone | 301-559-0461
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Fax | 202-635-5780
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | A000101014
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License Number State | MD
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