Provider Demographics
NPI:1104562792
Name:SEIDU AMINU, MAYENIN
Entity type:Individual
Prefix:
First Name:MAYENIN
Middle Name:
Last Name:SEIDU AMINU
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12844 HOLIDAY LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1140
Mailing Address - Country:US
Mailing Address - Phone:240-791-1655
Mailing Address - Fax:
Practice Address - Street 1:446 RIDGE RD APT 5
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-1645
Practice Address - Country:US
Practice Address - Phone:240-791-1655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-07
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide