Provider Demographics
NPI:1922347657
Name:MARY TABI
Entity Type:Organization
Organization Name:MARY TABI
Other - Org Name:MARY TABI
Other - Org Type:Other Name
Authorized Official - Title/Position:HHA
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:M
Authorized Official - Last Name:TABI
Authorized Official - Suffix:
Authorized Official - Credentials:HOME HEALTH AIDE
Authorized Official - Phone:240-478-5903
Mailing Address - Street 1:9910 MARTIN AVE
Mailing Address - Street 2:
Mailing Address - City:GLENN DALE
Mailing Address - State:MD
Mailing Address - Zip Code:20769-9227
Mailing Address - Country:US
Mailing Address - Phone:240-476-5903
Mailing Address - Fax:
Practice Address - Street 1:9910 MARTIN AVE
Practice Address - Street 2:
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769
Practice Address - Country:US
Practice Address - Phone:240-478-5903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization