Provider Demographics
NPI:1083268924
Name:AGZA, ZEITU
Entity Type:Individual
Prefix:
First Name:ZEITU
Middle Name:
Last Name:AGZA
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 1:400 TAYLOR ST NE APT 22A
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-1574
Mailing Address - Country:US
Mailing Address - Phone:202-981-9514
Mailing Address - Fax:
Practice Address - Street 1:14101 WILLARD RD STE C
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-2934
Practice Address - Country:US
Practice Address - Phone:703-955-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC39542623747P1801X
MDA00195317376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant