MEDICARE: TOMIKA YOUNG

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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1669991253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TOMIKA YOUNG

Provider Business Mailing Address
First Line	:	4446 ORD ST NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20019-1960
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4446 ORD ST NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20019-1960
Country	:	US
Telephone Number	:	240-346-8581
Fax Number	:

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

Provider Enumeration Date	:	09/14/2017
Last Update Date	:	09/14/2017

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Directions to “ TOMIKA YOUNG ” Practice Location

Language	Start Address	Practice Location

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