Provider Demographics
NPI:1063775583
Name:LIVINGSTON, ANGELICA MARIA
Entity type:Individual
Prefix:MS
First Name:ANGELICA
Middle Name:MARIA
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4110 AMES ST NE
Mailing Address - Street 2:APT 204
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-3309
Mailing Address - Country:US
Mailing Address - Phone:240-291-4593
Mailing Address - Fax:
Practice Address - Street 1:4110 AMES ST NE
Practice Address - Street 2:APT 204
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-3309
Practice Address - Country:US
Practice Address - Phone:240-291-4593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide