Provider Demographics
NPI:1972311934
Name:MENSANVI, ADJO
Entity type:Individual
Prefix:
First Name:ADJO
Middle Name:
Last Name:MENSANVI
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 1:4523 DAVIS AVE APT 103
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-5026
Mailing Address - Country:US
Mailing Address - Phone:319-427-1736
Mailing Address - Fax:
Practice Address - Street 1:4523 DAVIS AVE APT 103
Practice Address - Street 2:
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-5026
Practice Address - Country:US
Practice Address - Phone:319-427-1736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide