Provider Demographics
NPI:1053672410
Name:NYA, CELESTIN
Entity Type:Individual
Prefix:
First Name:CELESTIN
Middle Name:
Last Name:NYA
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 1:2501 FALLING BROOK TER
Mailing Address - Street 2:
Mailing Address - City:ADELPHI
Mailing Address - State:MD
Mailing Address - Zip Code:20783-1448
Mailing Address - Country:US
Mailing Address - Phone:240-515-2189
Mailing Address - Fax:
Practice Address - Street 1:2501 FALLING BROOK TER
Practice Address - Street 2:
Practice Address - City:ADELPHI
Practice Address - State:MD
Practice Address - Zip Code:20783-1448
Practice Address - Country:US
Practice Address - Phone:240-515-2189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-01
Last Update Date:2012-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide