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General NPI Number Information
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NPI Number | 1750292256
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Entity Type | Individual
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Provider Name | JOHNATHAN TAYI FORFU
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Gender | Male
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Dates
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Enumeration Date | 09/14/2026
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Last Update Date | 09/14/2026
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Provider Practice Location Address
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Address Line | 1818 NEW YORK AVE NE STE 221
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City | WASHINGTON
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State | DC
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Zip | 20002-1851
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Country | US
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Telephone | 202-800-6440
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Fax | 202-899-6994
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Provider Business Mailing Address
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Address Line | 3346 TEAGAREN CIRCLE SILVER SPRING APT 303 3346 TEAGAREN CIRCLE SILVER SPRING APT 303
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City | SILVER SPRING
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State | MD
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Zip | 20904
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Country | US
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Telephone | 571-640-0334
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Fax |
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 370275
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License Number State | WA
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