Provider Demographics
NPI:1609631308
Name:ADOMAKO, CECELIA
Entity Type:Individual
Prefix:
First Name:CECELIA
Middle Name:
Last Name:ADOMAKO
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 1:3511 KATRINA CT
Mailing Address - Street 2:
Mailing Address - City:TRIANGLE
Mailing Address - State:VA
Mailing Address - Zip Code:22172-2062
Mailing Address - Country:US
Mailing Address - Phone:703-389-1332
Mailing Address - Fax:
Practice Address - Street 1:3511 KATRINA CT
Practice Address - Street 2:
Practice Address - City:TRIANGLE
Practice Address - State:VA
Practice Address - Zip Code:22172-2062
Practice Address - Country:US
Practice Address - Phone:703-389-1332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-252835251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care