Provider Demographics
NPI:1801218722
Name:HAZOUME, ERIC
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:HAZOUME
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 1:3216 WHISPERING PINES DR APT 32
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-2454
Mailing Address - Country:US
Mailing Address - Phone:240-893-7652
Mailing Address - Fax:
Practice Address - Street 1:3216 WHISPERING PINES DR APT 32
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-2454
Practice Address - Country:US
Practice Address - Phone:240-893-7652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-12
Last Update Date:2014-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA9101163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health