Provider Demographics
NPI:1922796416
Name:DOZA, ABDUL CEESAY (CRNP-PMH)
Entity Type:Individual
Prefix:
First Name:ABDUL
Middle Name:CEESAY
Last Name:DOZA
Suffix:
Gender:M
Credentials:CRNP-PMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 JUMPERS HOLE RD STE 217
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-1046
Mailing Address - Country:US
Mailing Address - Phone:240-883-4025
Mailing Address - Fax:410-415-3722
Practice Address - Street 1:8000 JUMPERS HOLE RD STE 217
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-1046
Practice Address - Country:US
Practice Address - Phone:240-883-4025
Practice Address - Fax:410-415-3722
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR226469363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health