MEDICARE: MEDICAL OUTREACH INC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1720930878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL OUTREACH INC

Provider Business Mailing Address
First Line	:	16582 KENNEDY CIR
Second Line	:
City	:	SHREWSBURY
State	:	PA
Zip	:	17361-1868
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 BALTISTAN CT
Second Line	:
City	:	ROSEDALE
State	:	MD
Zip	:	21237-4024
Country	:	US
Telephone Number	:	708-218-5908
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NGOZIKA OKOYE
Credential	:
Telephone Number	:	708-218-5908

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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Directions to “MEDICAL OUTREACH INC ” Practice Location

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