Provider Demographics
NPI:1659761484
Name:AGARIB, YAHIA
Entity Type:Individual
Prefix:
First Name:YAHIA
Middle Name:
Last Name:AGARIB
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6122 BREEZEWOOD DR APT 102
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-4124
Mailing Address - Country:US
Mailing Address - Phone:240-487-8782
Mailing Address - Fax:
Practice Address - Street 1:12601 LAYHILL RD APT 202
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-3404
Practice Address - Country:US
Practice Address - Phone:240-487-8782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-02
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA9135163WH0200X
374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No163WH0200XNursing Service ProvidersRegistered NurseHome Health