Provider Demographics
NPI:1720539976
Name:ATAH, ROJAH
Entity Type:Individual
Prefix:
First Name:ROJAH
Middle Name:
Last Name:ATAH
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 1:3426 DODGE PARK RD
Mailing Address - Street 2:APT 103
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-2051
Mailing Address - Country:US
Mailing Address - Phone:240-495-9201
Mailing Address - Fax:
Practice Address - Street 1:3426 DODGE PARK RD
Practice Address - Street 2:APT 103
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-2051
Practice Address - Country:US
Practice Address - Phone:240-495-9201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-21
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11903374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide