Provider Demographics
NPI:1316747298
Name:TSIYYON ZION PRIMARY CARE AND WELLNESS CENTER LLC
Entity type:Organization
Organization Name:TSIYYON ZION PRIMARY CARE AND WELLNESS CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NDIFREKE
Authorized Official - Middle Name:
Authorized Official - Last Name:ENYEAMA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:240-552-5898
Mailing Address - Street 1:9 SCHILLING RD STE LL4
Mailing Address - Street 2:
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21031-8616
Mailing Address - Country:US
Mailing Address - Phone:240-552-5898
Mailing Address - Fax:
Practice Address - Street 1:9 SCHILLING RD STE LL4
Practice Address - Street 2:
Practice Address - City:HUNT VALLEY
Practice Address - State:MD
Practice Address - Zip Code:21031-8616
Practice Address - Country:US
Practice Address - Phone:443-845-3037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-18
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty