Individual
MISS PRISCILLA DOREEN MOMOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSC
Contact information
Practice address
1949 4TH ST NE, WASHINGTON, DC 20002-1211
(202) 462-7500
(202) 462-2309
Mailing address
2109 SARANAC ST, HYATTSVILLE, MD 20783-2166
(202) 462-7500
(202) 462-2309
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
C0002552
MD
363AM0700X
Medical Physician Assistant
Primary
PA30224
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037410900
—
DC
Enumeration date
06/24/2010
Last updated
06/24/2010
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