Provider Demographics
NPI:1215584636
Name:POCH, TATIANA CORREY
Entity Type:Individual
Prefix:
First Name:TATIANA
Middle Name:CORREY
Last Name:POCH
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 1:17821 BUEHLER RD APT 104
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-2351
Mailing Address - Country:US
Mailing Address - Phone:240-821-2006
Mailing Address - Fax:
Practice Address - Street 1:2021 TUNLAW RD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2220
Practice Address - Country:US
Practice Address - Phone:413-652-1540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide