MEDICARE: GANI NWAOGBE

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	251B00000X	Case Management Agency
2	374U00000X	Home Health Aide	HHA11409	DC

General Provider Information

NPI Number	:	1710363544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GANI NWAOGBE

Provider Business Mailing Address
First Line	:	8150 LAKECREST DR
Second Line	:
City	:	GREENBELT
State	:	MD
Zip	:	20770-3334
Country	:	US
Telephone Number	:	240-280-5060
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 EASTERN AVE NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20019-2833
Country	:	US
Telephone Number	:	202-248-1356
Fax Number	:

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

Provider Enumeration Date	:	08/04/2015
Last Update Date	:	10/28/2022

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Directions to “ GANI NWAOGBE ” Practice Location

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