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NPI Code Detail

MEDICARE: RAISSA FODJO

MEDICARE:   RAISSA  FODJO
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
1374U00000XHome Health AideDC

General Provider Information

NPI Number : 1194160176
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAISSA FODJO
Provider Business Mailing Address
First Line : 9603 MOUNT PISGAH RD
Second Line :
City : SILVER SPRING
State : MD
Zip : 20903-2328
Country : US
Telephone Number : 202-832-8340
Fax Number :
Provider Business Practice Location Address
First Line : 9603 MOUNT PISGAH RD
Second Line :
City : SILVER SPRING
State : MD
Zip : 20903-2328
Country : US
Telephone Number : 202-832-8340
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2013
Last Update Date : 05/06/2013

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Directions to “ RAISSA FODJO ” Practice Location

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