Provider Demographics
NPI:1235785023
Name:KOROMA, SAFFIE TEMPLE
Entity Type:Individual
Prefix:MISS
First Name:SAFFIE
Middle Name:TEMPLE
Last Name:KOROMA
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 1:5101 57TH AVE APT 201
Mailing Address - Street 2:
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-1623
Mailing Address - Country:US
Mailing Address - Phone:202-431-7422
Mailing Address - Fax:
Practice Address - Street 1:301 G ST SW APT 122
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-3108
Practice Address - Country:US
Practice Address - Phone:202-431-7422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-16
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant