MEDICARE: ALVINE ANYE EPSE FORBAH

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	HHA13616	DC

General Provider Information

NPI Number	:	1790273035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALVINE ANYE EPSE FORBAH

Provider Business Mailing Address
First Line	:	5457 MADISON WAY APT 7
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20784
Country	:	US
Telephone Number	:	239-841-6235
Fax Number	:

Provider Business Practice Location Address
First Line	:	5457 MADISON WAY APT 7
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20784-1053
Country	:	US
Telephone Number	:	239-841-6235
Fax Number	:

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

Provider Enumeration Date	:	04/23/2018
Last Update Date	:	04/23/2018

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Directions to “ ALVINE ANYE EPSE FORBAH ” Practice Location

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