Provider Demographics
NPI:1073937439
Name:OFON, PRISCA (HHA)
Entity Type:Individual
Prefix:MISS
First Name:PRISCA
Middle Name:
Last Name:OFON
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9226 WILLOW LN
Mailing Address - Street 2:
Mailing Address - City:ADELPHI
Mailing Address - State:MD
Mailing Address - Zip Code:20783-1501
Mailing Address - Country:US
Mailing Address - Phone:240-475-3382
Mailing Address - Fax:
Practice Address - Street 1:9226 WILLOW LN
Practice Address - Street 2:
Practice Address - City:ADELPHI
Practice Address - State:MD
Practice Address - Zip Code:20783-1501
Practice Address - Country:US
Practice Address - Phone:240-475-3382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA7176374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide