Provider Demographics
NPI:1285118216
Name:LEUMANI SIANI, CHRYSOSTOME A
Entity type:Individual
Prefix:MR
First Name:CHRYSOSTOME A
Middle Name:
Last Name:LEUMANI SIANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4410 OGLETHORPE ST APT 711
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20781-1562
Mailing Address - Country:US
Mailing Address - Phone:240-491-7855
Mailing Address - Fax:
Practice Address - Street 1:4410 OGLETHORPE ST APT 711
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20781-1562
Practice Address - Country:US
Practice Address - Phone:240-491-7855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-15
Last Update Date:2018-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13980374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide