Provider Demographics
NPI:1508125220
Name:OBEN, AYAMBA ROSELYNE
Entity Type:Individual
Prefix:MS
First Name:AYAMBA
Middle Name:ROSELYNE
Last Name:OBEN
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 1:3500 18TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-2738
Mailing Address - Country:US
Mailing Address - Phone:202-529-6510
Mailing Address - Fax:
Practice Address - Street 1:1521 KANAWHA ST APT 206
Practice Address - Street 2:
Practice Address - City:ADELPHI
Practice Address - State:MD
Practice Address - Zip Code:20783-6827
Practice Address - Country:US
Practice Address - Phone:202-476-9970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide