Provider Demographics
NPI:1639808843
Name:ABASIAMA JIMMY
Entity Type:Organization
Organization Name:ABASIAMA JIMMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNA
Authorized Official - Prefix:MR
Authorized Official - First Name:ABASIAMA
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMMY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-820-0735
Mailing Address - Street 1:2378 GLENMOUNT CIR
Mailing Address - Street 2:APT 110
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902
Mailing Address - Country:US
Mailing Address - Phone:202-820-0735
Mailing Address - Fax:
Practice Address - Street 1:2378 GLENMOUNT CIR
Practice Address - Street 2:APT 110
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902
Practice Address - Country:US
Practice Address - Phone:202-820-0735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty