Provider Demographics
NPI:1467079913
Name:NAMIIRO, AISHA MAKUMBI (NURSING ASSISTANT)
Entity Type:Individual
Prefix:
First Name:AISHA
Middle Name:MAKUMBI
Last Name:NAMIIRO
Suffix:
Gender:F
Credentials:NURSING ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:879 LEXINGTON ST APT 4A
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02452-4851
Mailing Address - Country:US
Mailing Address - Phone:857-312-4718
Mailing Address - Fax:
Practice Address - Street 1:6225 SMITH AVE STE 1001A
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-3626
Practice Address - Country:US
Practice Address - Phone:410-369-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician