Provider Demographics
NPI:1932658259
Name:FORCHICK, CYNTHIA ENJEI
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ENJEI
Last Name:FORCHICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2506 QUEENS CHAPEL RD
Mailing Address - Street 2:APT 301
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-3647
Mailing Address - Country:US
Mailing Address - Phone:240-533-6852
Mailing Address - Fax:
Practice Address - Street 1:2506 QUEENS CHAPEL RD
Practice Address - Street 2:APT 301
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-3647
Practice Address - Country:US
Practice Address - Phone:240-533-6852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-28
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12388374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide