Provider Demographics
NPI:1578954715
Name:MUSIKA, DAVID (LPN)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:MUSIKA
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:MR
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:MUSIKA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:6856 EASTERN AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-2165
Mailing Address - Country:US
Mailing Address - Phone:202-545-6980
Mailing Address - Fax:
Practice Address - Street 1:6856 EASTERN AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-2165
Practice Address - Country:US
Practice Address - Phone:202-545-6980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-10
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLPN1004712374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC37Medicaid