Provider Demographics
NPI:1295192367
Name:REAMOH, LYNDA
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:
Last Name:REAMOH
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 1:6219 FERNWOOD TER
Mailing Address - Street 2:APT 202
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1639
Mailing Address - Country:US
Mailing Address - Phone:240-476-7566
Mailing Address - Fax:
Practice Address - Street 1:6219 FERNWOOD TER
Practice Address - Street 2:APT 202
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1639
Practice Address - Country:US
Practice Address - Phone:240-476-7566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-20
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11763374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCHHA11763Medicare PIN