Provider Demographics
NPI:1679827240
Name:MBAH, SCOLA API
Entity Type:Individual
Prefix:
First Name:SCOLA
Middle Name:API
Last Name:MBAH
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 1:3307 CHAUNCEY PL APT 101
Mailing Address - Street 2:
Mailing Address - City:MOUNT RAINIER
Mailing Address - State:MD
Mailing Address - Zip Code:20712
Mailing Address - Country:US
Mailing Address - Phone:240-476-6366
Mailing Address - Fax:
Practice Address - Street 1:2312 RHODE ISLAND AVE.
Practice Address - Street 2:
Practice Address - City:NE WASHINGTON D.C
Practice Address - State:MD
Practice Address - Zip Code:20018
Practice Address - Country:US
Practice Address - Phone:240-476-6366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN62612(D.C)374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide