Provider Demographics
NPI:1821434168
Name:TARKEH, VICTOR (HHA)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:TARKEH
Suffix:
Gender:M
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15902 BISHOPSTONE TER
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-8009
Mailing Address - Country:US
Mailing Address - Phone:240-422-5354
Mailing Address - Fax:
Practice Address - Street 1:15902 BISHOPSTONE TER
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-8009
Practice Address - Country:US
Practice Address - Phone:240-422-5354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide