Emmanuel Asaha Jijong

Individual provider Active NPI Home Health Aide · Glenarden, MD

NPI 1194480608 · NPPES record last updated Nov 11, 2021

Key facts

NPI
1194480608
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Aide 374U00000X
License
HHA200001337 (DC)
Practice address
3635 Cousins Dr
Glenarden, MD 20774-2600
Phone
(240) 476-9651
NPI assigned
Nov 1, 2021
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
HHA200001337DCMDHome Health Aide

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X HHA200001337 DC Yes

Addresses

Primary practice location

3635 Cousins Dr
Glenarden, MD 20774-2600

Mailing address

3635 Cousins Dr
Glenarden, MD 20774-2600
Phone (240) 476-9651

Other providers in Glenarden, MD

All providers in Glenarden, MD · Home Health Aide in Maryland

Sources for this page

Verify at the official NPI Registry.