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NPI Code Detail

MEDICARE: NAFEEZA BOBBY KAJA KAMALUDEEN

MEDICARE: NAFEEZA BOBBY KAJA KAMALUDEEN
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1184122970
Entity Type Code : Individual
Provider Name (Legal Business Name) : NAFEEZA BOBBY KAJA KAMALUDEEN
Provider Business Mailing Address
First Line : 22385 MAISON CARREE SQ
Second Line :
City : ASHBURN
State : VA
Zip : 20148-3113
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 46040 CENTER OAK PLZ
Second Line :
City : STERLING
State : VA
Zip : 20166-8539
Country : US
Telephone Number : 703-997-9494
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2018
Last Update Date : 01/26/2018

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Directions to “ NAFEEZA BOBBY KAJA KAMALUDEEN ” Practice Location

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