Provider Demographics
NPI:1851965156
Name:ISLAM, TARIQUL
Entity Type:Individual
Prefix:
First Name:TARIQUL
Middle Name:
Last Name:ISLAM
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 1:3101 NAYLOR RD SE APT 204
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-1673
Mailing Address - Country:US
Mailing Address - Phone:202-378-4310
Mailing Address - Fax:
Practice Address - Street 1:3101 NAYLOR RD SE APT 204
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-1673
Practice Address - Country:US
Practice Address - Phone:120-237-8431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant