Provider Demographics
NPI:1023509122
Name:NJOCK, PAUL ANICET
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:ANICET
Last Name:NJOCK
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 1:64 ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-2222
Mailing Address - Country:US
Mailing Address - Phone:240-690-1671
Mailing Address - Fax:
Practice Address - Street 1:64 ORCHARD DR
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-2222
Practice Address - Country:US
Practice Address - Phone:240-690-1671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13622374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide