Provider Demographics
NPI:1881205888
Name:EBAI, JUVET ASHU JR
Entity Type:Individual
Prefix:MR
First Name:JUVET
Middle Name:ASHU
Last Name:EBAI
Suffix:JR
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 1:13842 CASTLE BLVD APT T2
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-7387
Mailing Address - Country:US
Mailing Address - Phone:240-505-4940
Mailing Address - Fax:
Practice Address - Street 1:2304 HARTFORD ST SE APT 201
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-7964
Practice Address - Country:US
Practice Address - Phone:202-678-0539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA5333374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide