Provider Demographics
NPI:1518224237
Name:OZOBU, AGATHA NGOZI
Entity Type:Individual
Prefix:
First Name:AGATHA
Middle Name:NGOZI
Last Name:OZOBU
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 1:5291 85TH AVE
Mailing Address - Street 2:APT302
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-3253
Mailing Address - Country:US
Mailing Address - Phone:240-704-0151
Mailing Address - Fax:
Practice Address - Street 1:5291 85TH AVE
Practice Address - Street 2:APT302
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-3253
Practice Address - Country:US
Practice Address - Phone:240-704-0151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide