Provider Demographics
NPI:1679906069
Name:NDI, EDWIN
Entity Type:Individual
Prefix:
First Name:EDWIN
Middle Name:
Last Name:NDI
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 1:7600 GEORGIA AVENUE, SUITE 323
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012
Mailing Address - Country:US
Mailing Address - Phone:202-723-3060
Mailing Address - Fax:202-723-3065
Practice Address - Street 1:7600 GEORGIA AVENUE, SUITE 323
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012
Practice Address - Country:US
Practice Address - Phone:202-723-3060
Practice Address - Fax:202-723-3065
Is Sole Proprietor?:No
Enumeration Date:2013-08-20
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
DC4517374U00000X
DCHHA9425374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide