Provider Demographics
NPI:1558500314
Name:AFRIYIE, JOYCE (ADMINISTRATOR)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:AFRIYIE
Suffix:
Gender:F
Credentials:ADMINISTRATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 743592
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274-1362
Mailing Address - Country:US
Mailing Address - Phone:404-781-8448
Mailing Address - Fax:
Practice Address - Street 1:1411 WYNTHROPE COVE
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-5145
Practice Address - Country:US
Practice Address - Phone:404-781-8448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA060-R-0484251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health