Provider Demographics
NPI:1215585856
Name:TCHWENKO, SANDRA ACHIE
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:ACHIE
Last Name:TCHWENKO
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 1:2010 RHODE ISLAND AVE NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-2835
Mailing Address - Country:US
Mailing Address - Phone:301-339-4396
Mailing Address - Fax:
Practice Address - Street 1:9727 MOUNT PISGAH RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-2019
Practice Address - Country:US
Practice Address - Phone:240-713-7526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-27
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14631374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide