Provider Demographics
NPI:1467831644
Name:CHO MAMA, SIRRIA MAFOR
Entity Type:Individual
Prefix:
First Name:SIRRIA MAFOR
Middle Name:
Last Name:CHO MAMA
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 1:3499 FORT MEADE RD
Mailing Address - Street 2:APT 2
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-2063
Mailing Address - Country:US
Mailing Address - Phone:202-378-7625
Mailing Address - Fax:
Practice Address - Street 1:3499 FORT MEADE RD
Practice Address - Street 2:APT 2
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20724-2063
Practice Address - Country:US
Practice Address - Phone:202-378-7625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-21
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide