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NPI Code Detail

MEDICARE: JULIUS NDE NDEAGA

MEDICARE:   JULIUS NDE NDEAGA
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
1104100000XSocial Worker
2171WH0202XHome Modifications Contractor
3172V00000XCommunity Health Worker
4171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1710720735
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIUS NDE NDEAGA
Provider Business Mailing Address
First Line : 8432 FIELDSTONE WAY
Second Line :
City : HYATTSVILLE
State : MD
Zip : 20785-4778
Country : US
Telephone Number : 240-424-1516
Fax Number :
Provider Business Practice Location Address
First Line : 8432 FIELDSTONE WAY
Second Line :
City : HYATTSVILLE
State : MD
Zip : 20785-4778
Country : US
Telephone Number : 240-424-1516
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2024
Last Update Date : 06/17/2024

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Directions to “ JULIUS NDE NDEAGA ” Practice Location

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