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General NPI Number Information
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NPI Number | 1780366187
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Entity Type | Individual
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Provider Name | YVES BAKALAG
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Gender | Male
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Dates
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Enumeration Date | 08/04/2023
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Last Update Date | 08/04/2023
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Provider Practice Location Address
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Address Line | 2311 GREEN ST SE APT 2
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City | WASHINGTON
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State | DC
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Zip | 20020-7347
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Country | US
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Telephone | 202-725-2027
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Fax |
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Provider Business Mailing Address
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Address Line | 12648 GREY EAGLE CT APT 44
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City | GERMANTOWN
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State | MD
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Zip | 20874-5317
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Country | US
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Telephone |
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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