Individual
JUSTICE EZUOKEABA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6025 67TH AVE APT 4, RIVERDALE, MD 20737-1767
(202) 718-6877
Mailing address
6025 67TH AVE APT 4, RIVERDALE, MD 20737-1767
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA9491
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HHA9491
DISTRICT OF COLUMBIA DEPARTMENT OF HEALTH
DC
Enumeration date
11/02/2013
Last updated
11/02/2013
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