MEDICARE: IYANGDAM PATRICIA

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	171M00000X	Case Manager/Care Coordinator
2	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1386528883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IYANGDAM PATRICIA

Provider Business Mailing Address
First Line	:	3338 ANABRANCH WAY
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20724-0002
Country	:	US
Telephone Number	:	202-897-8163
Fax Number	:

Provider Business Practice Location Address
First Line	:	6323 GEORGIA AVE NW STE 360
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20011-1101
Country	:	US
Telephone Number	:	202-621-8494
Fax Number	:

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

Provider Enumeration Date	:	08/05/2025
Last Update Date	:	05/04/2026

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Directions to “ IYANGDAM PATRICIA ” Practice Location

Language	Start Address	Practice Location

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