Individual
NOSTA TANYIDAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7813 MANDAN RD, T2, GREENBELT, MD 20770-2139
(202) 391-1159
Mailing address
7813 MANDAN RD, T2, GREENBELT, MD 20770-2139
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
HHA10348
DC
Other
Enumeration date
10/29/2014
Last updated
10/29/2014
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