Provider Demographics
NPI:1013587328
Name:TIKU, GEORGES NJECKY
Entity Type:Individual
Prefix:MR
First Name:GEORGES
Middle Name:NJECKY
Last Name:TIKU
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 1:5914 85TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-2802
Mailing Address - Country:US
Mailing Address - Phone:240-722-7940
Mailing Address - Fax:
Practice Address - Street 1:5914 85TH AVE
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-2802
Practice Address - Country:US
Practice Address - Phone:240-722-7940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide