Provider Demographics
NPI:1326309170
Name:FOSSI, PIERRE SIPOWA
Entity Type:Individual
Prefix:
First Name:PIERRE
Middle Name:SIPOWA
Last Name:FOSSI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11502 LOCKWOOD DR
Mailing Address - Street 2:APT B1
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2404
Mailing Address - Country:US
Mailing Address - Phone:301-377-1569
Mailing Address - Fax:
Practice Address - Street 1:11502 LOCKWOOD DR
Practice Address - Street 2:APT B1
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2404
Practice Address - Country:US
Practice Address - Phone:301-377-1569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide