Provider Demographics
NPI:1306664792
Name:NYAH, KELVIN CHAH
Entity type:Individual
Prefix:
First Name:KELVIN
Middle Name:CHAH
Last Name:NYAH
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 1:11716 CIDER PRESS PL
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-2710
Mailing Address - Country:US
Mailing Address - Phone:301-401-8096
Mailing Address - Fax:
Practice Address - Street 1:1615 RHODE ISLAND AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-1802
Practice Address - Country:US
Practice Address - Phone:202-832-1698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator