Provider Demographics
NPI:1104302959
Name:EBAI, NELIESTEVE
Entity type:Individual
Prefix:
First Name:NELIESTEVE
Middle Name:
Last Name:EBAI
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 1:2400 QUEENS CHAPEL RD APT 7
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-3631
Mailing Address - Country:US
Mailing Address - Phone:240-971-9497
Mailing Address - Fax:
Practice Address - Street 1:11342 CHERRY HILL RD
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-3735
Practice Address - Country:US
Practice Address - Phone:301-803-9991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-16
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No374U00000XNursing Service Related ProvidersHome Health Aide