Provider Demographics
NPI:1386997534
Name:EJOH, ANYI ALFRED
Entity type:Individual
Prefix:
First Name:ANYI
Middle Name:ALFRED
Last Name:EJOH
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 1:6852 RIVERDALE RD
Mailing Address - Street 2:APT.101
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-1053
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6852 RIVERDALE RD
Practice Address - Street 2:APT,101
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-1053
Practice Address - Country:US
Practice Address - Phone:240-354-3066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide