MEDICARE: KENNETH OSUJI

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	374U00000X	Home Health Aide

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376804195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH OSUJI

Provider Business Mailing Address
First Line	:	2512 24TH ST NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20018-2126
Country	:	US
Telephone Number	:	202-832-8340
Fax Number	:

Provider Business Practice Location Address
First Line	:	2512 24TH ST NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20018-2126
Country	:	US
Telephone Number	:	202-832-8340
Fax Number	:

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

Provider Enumeration Date	:	06/07/2012
Last Update Date	:	01/13/2017

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Directions to “ KENNETH OSUJI ” Practice Location

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