MEDICARE: AALIYAH NURIDEEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	44SL06429900	NJ
2	1041C0700X	Clinical Social Worker	44SC06015990	NJ
3	1041C0700X	Clinical Social Worker	27794	MD

General Provider Information

NPI Number	:	1013489392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AALIYAH NURIDEEN

Provider Business Mailing Address
First Line	:	5348 CENTRAL AVE SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20019-6412
Country	:	US
Telephone Number	:	908-432-2519
Fax Number	:

Provider Business Practice Location Address
First Line	:	2850 N RIDGE RD STE 210
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-3463
Country	:	US
Telephone Number	:	410-203-1649
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/26/2018
Last Update Date	:	09/11/2023

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Directions to “ AALIYAH NURIDEEN ” Practice Location

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