MEDICARE: ERNEST J FIYUFE

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

General Provider Information

NPI Number	:	1528325099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERNEST J FIYUFE

Provider Business Mailing Address
First Line	:	7600 MAPLE AVE
Second Line	:	APT# 310
City	:	TAKOMA PARK
State	:	MD
Zip	:	20912-5571
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7600 MAPLE AVE
Second Line	:	APT# 310
City	:	TAKOMA PARK
State	:	MD
Zip	:	20912-5571
Country	:	US
Telephone Number	:	202-722-1725
Fax Number	:

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

Provider Enumeration Date	:	04/20/2012
Last Update Date	:	04/20/2012

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