Provider Demographics
NPI:1598023129
Name:BOUABEY, ANANI
Entity type:Individual
Prefix:
First Name:ANANI
Middle Name:
Last Name:BOUABEY
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 1:10153 CAMPUS WAY S
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-2105
Mailing Address - Country:US
Mailing Address - Phone:240-832-5389
Mailing Address - Fax:
Practice Address - Street 1:2312 RHODE ISLAND AVENE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018
Practice Address - Country:US
Practice Address - Phone:202-635-6006
Practice Address - Fax:202-636-1936
Is Sole Proprietor?:No
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide