Provider Demographics
NPI:1306101498
Name:ALBERT, DAVID IKECHUKWU (HOMER HEALTH AIDE)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:IKECHUKWU
Last Name:ALBERT
Suffix:
Gender:M
Credentials:HOMER HEALTH AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5332 85TH AVE # NUE
Mailing Address - Street 2:APT 3 C-5
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-3235
Mailing Address - Country:US
Mailing Address - Phone:240-640-3582
Mailing Address - Fax:
Practice Address - Street 1:5332 85TH AVE # NUE
Practice Address - Street 2:APT 3 C-5
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-3235
Practice Address - Country:US
Practice Address - Phone:240-640-3582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide