Provider Demographics
NPI:1962685362
Name:KANJI, FAMIDA
Entity type:Individual
Prefix:
First Name:FAMIDA
Middle Name:
Last Name:KANJI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14107 NORTHWYN DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-5929
Mailing Address - Country:US
Mailing Address - Phone:716-725-1805
Mailing Address - Fax:855-655-5326
Practice Address - Street 1:2700 LIGHTHOUSE PT E STE 402
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-4769
Practice Address - Country:US
Practice Address - Phone:866-667-2460
Practice Address - Fax:855-655-5326
Is Sole Proprietor?:No
Enumeration Date:2007-12-10
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1962685362Medicare UPIN