Provider Demographics
NPI:1043990823
Name:MACELLINUS ALEAFE A AG, UNKNOWN
Entity Type:Individual
Prefix:
First Name:UNKNOWN
Middle Name:
Last Name:MACELLINUS ALEAFE A AG
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 1:5652 WHITFIELD CHAPEL RD APT 303
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2564
Mailing Address - Country:US
Mailing Address - Phone:240-729-6106
Mailing Address - Fax:
Practice Address - Street 1:5652 WHITFIELD CHAPEL RD APT 303
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2564
Practice Address - Country:US
Practice Address - Phone:240-729-6106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide